Risk factors for pancreatic fistula following distal pancreatectomy: a retrospective study of 211 consecutive patients

Abstract

Background Postoperative pancreatic fistula (POPF) is a common complication following distal pancreatectomy (DP). Although the mortality from these procedures has decreased in the past decades, the rate of POPF remains high. The aim of this study was to identify risk factors associated with POPF after DP. Methods A retrospective review of a consecutive series of 211 patients who had undergone DP between January 2016 and October 2018 at a single institution was conducted. Patient demographic data, perioperative data and clinicopathological parameters were analysed to evaluate their correlation with the incidence of POPF using univariate and multivariate models. POPFs were defined by 2016 International Study Group criteria. Results Two hundred eleven consecutive patients were identified. The overall pancreatic fistula rate was 15.64%, and no 30-day or 90-day mortality was seen. Four predictors were independently associated with POPF: soft pancreatic texture (odds ratio (OR): 4.23, 95% confidence interval (CI): 1.71-10.45, P = 0.002), longer operating time (OR: 4.18, 95% CI: 1.67–10.46, P = 0.002), higher difference of albumin (OR: 6.41, 95% CI: 2.40–17.08, P <0.001), and history of cardiovascular disease(OR: 5.05, 95% CI: 1.97-13.01, P = 0.001). Conclusions Although DP can be performed with a low rate of mortality, POPF remains a common complication. Pancreatic texture, operating time, the difference of albumin and cardiovascular disease were risk factors for POPF after DP.