Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy

Abstract

AIM:To analyze the risk factors of pancreatic leakage after pancreaticoduodenectomy. METHODS:We r e t r o s p e c t i v e l y r e v i e w e d 1 7 2 consecutive patients who had undergone pancreaticoduodenectomy at Inha University Hospital between April 1996 and March 2006. We analyzed the pancreatic fistula rate according to the clinical characteristics, the pathologic and laboratory findings, and the anastomotic methods. RESULTS: The incidence of developing pancreatic fistulas in patients older than 60 years of age was 21.7% (25/115), while the incidence was 8.8% (5/57) for younger patients; the difference was significant (P = 0.03). Patients with a dilated pancreatic duct had a lower rate of post-operative pancreatic fistulas than patients with a non-dilated duct (P = 0.001). Other factors, including clinical features, anastomotic methods, and pathologic diagnosis, did not show any statistical difference. CONCLUSION: O u r s t u d y d e m o n s t ra t e d t h a t pancreatic fistulas are related to age and a dilated pancreatic duct. The surgeon must take these risk factors into consideration when performing a pancreaticoduodenectomy.

Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

“…Of the many types of complications that occur after PD, pancreatic fistula was the most significant and complicated. Previous studies revealed that the pancreatic fistula rate following resection of nonampullary duodenal tumors is 10-63% [27][28][29][30][31][32][33][34]. In our study, the pancreatic fistula rate for duodenal GISTs treated with PD was 14.3%, which is in the range mentioned in previous reports.…”

Application of Polyethylene Glycolic Acid Felt with Fibrin Sealant to Prevent Postoperative Pancreatic Fistula in Pancreatic Surgery

“…Reported risk factors of POPF in PD in patients older than 60 years of age include nondilated duct size, longer operative time, greater intraoperative red blood cell transfusions, lower surgical volume, and soft texture. [9][10][11] With regard to the anastomotic procedure, duct-to-mucosa pancreaticojejunostomy and external drainage of the pancreatic duct with a stent have been recommended; 12 the efficacy of those procedures, however, remains controversial. In DP, we previously cut the stump of the remnant pancreas using a knife, then subsequently ligated the main pancreatic duct and sutured the tissue of the pancreas to close.…”

An analysis of risk factors for pancreatic fistula after robotic pancreaticoduodenectomy: outcomes from a consecutive series of standardized pancreatic reconstructions

“…Most of these approaches have been met with varying success. Others have developed prognostic scores to predict the risk of POPF [11,12,[29][30][31]. Although, both Braga and Callery scores are useful tools in predicting complications and POPF after OPD, respectively, they have not been validated for minimally invasive approaches.…”