Analysis Of Risk Factors Related To Pancreatic Fistula After Laparoscopic Pancreatic Surgery

ObjectiveTo explore the risk factors and prevention measures of common clinical complications after complete laparoscopic pancreatic surgery.MethodsThe perioperative information of 71 patients undergoing laparoscopic pancreatic surgery conducted by the same team in heze municipal hospital from January 2018 to February 2019 was retrospectively analyzed,including 13 cases of laparoscopic pancreaticoduodenectomy(LPD),36 cases of laparoscopic distal pancreatectomy(LDP)and22 cases of laparoscopic pancreatic tumor resection,and compared with the open pancreatic surgery group conducted at the same time,the single factor and multiple factor analysis were conducted on the related influencing factors of pancreatic fistula after laparoscopic pancreatic surgery,and the prevention and treatment experience was summarized.ResultsThe total incidence of pancreatic fistula(grade B and grade C pancreatic fistula)in the laparoscopic group was 36.62%(26/71),among which the incidence of grade B and grade C pancreatic fistula was 29.58% and 7.04% respectively;The total incidence of pancreatic fistula in the open group was 25.45%(21/86),among which the incidence of grade B and grade C pancreatic fistula was 18.72% and 6.73%,respectively.Compared between the two groups,the incidence of grade B pancreatic fistula was slightly higher in the endoscopic group,and the incidence of grade C pancreatic fistula was basically the same in the two groups.Single Factor Analysis was conducted on the risk factors that might affect pancreatic fistula after pancreatic surgery in the endoscopic group.Age,gender,diabetes,preoperative albumin,hemoglobin,blood transfusion and other factors had no statistical significance in pancreatic fistula(P>0.05),hyperbilirubinemia,intraoperative blood loss,operation time and pancreatic duct diameter <3 mm are the single risk factors for pancreatic fistula after pancreatic surgery(P<0.05).The results of single influencing factor were further introduced into the logistics analysis,which showed that intraoperative blood loss and pancreatic duct diameter <3 mm were independent risk factors for pancreatic fistula after pancreatic surgery.Conclusion:Laparoscopic pancreatic surgery offers similar results to open surgery,The risk factors of pancreatic fistula after laparoscopic pancreatic surgery are various,in this study,hyperbilirubinemia,intraoperative blood loss,operation time and pancreatic duct diameter<3mm are the main single risk factors,among which intraoperative blood loss and pancreatic duct diameter <3mm are the independent risk factors affecting postoperative pancreatic fistula.