Analysis Of Postoperative Complications And Risk Factors Of Patients With Pancreaticoduodenectomy Through Clavien-Dindo Classification

Objective: Clavien.Dindo classification system was used to classify the severity of short-term complications after pancreaticoduodenectomy;and to explore the independent influencing factors of pancreaticoduodenectomy complications.Methods: Collected the Clinical data of 151 patients who have accepted pancreatoduodenectomy(including open pancreaticoduodenectomy and laparoscopic pancreaticoduodenectomy)in the Department of Hepatobiliary Surgery,in the First Affiliated Hospital of Chongqing Medical University from January 2015 to December 2018.According to the Clavien.Dindo classification system,the severity of postoperative complications was graded,and Clavien.Dindo classification was used as the outcome variable to explore the independent influencing factors of the severity of postoperative complications..Results: 151 patients was included in this article,23 patients(15.2%)had postoperative complications with CD grade ≥3.Among patients withpostoperative complications,there were 27 cases of postoperative bleeding,38 cases of pancreatic fistula(32 cases of grade AB pancreatic fistula,6cases of grade C pancreatic fistula),12 cases of biliary fistula,9 cases of reoperation,Nine cases died during the operation.More than one complication occurred in 32 patients.Univariate logistic analysis showed that ASA grade Ⅲ,soft pancreas,surgical method,and the total number of white blood cells on the fifth postoperative day(all P values <0.05)were associated with the severity of postoperative complications.The results of multivariate analysis showed that ASA grade Ⅲ and above,pancreatic texture,and the total number of white blood cells on the fifth postoperative day were independent influencing factors for the postoperative Clavien.Dindo grade(all P values <0.05).Conclusion: Clavien.Dindo grading system can be used for the preliminary evaluation of postoperative complications of patients after pancreaticoduodenectomy,which can provide a certain reference for early clinical management and intervention.ASA grade Ⅲ,soft pancreas,and the total number of white blood cells on the fifth postoperative day are independent risk factors for the severity of postoperative complications.