The Clinical Analysis Of Correlation Between Pancreatic Leakage And Associated-therapeutic Factors After Pancreaticoduodenectomy

Objective:Combined with the literatures ,the author discussed the correlation between the occurrence of pancreatic leakage and the different clinical treatment measures given ,to expect to get new discovery for guiding the clinical treatment .Methods: Patients who underwent PD at the first affiliated Hospital of Medcial College of nanchang University between Jun. 2002 and Oct. 2007 were enrolled . We conducted a retrospective review of these patients ,to investigate the complication pancreatic leakage and to analysis the correlation between the occurrence of pancreatic leakage and the different clinical treatment measures given . all kinds of trentmemt factors given included two aspects : 1. the surgeon-related factors,such as operative technique ( removal range) , pancreatic anastomotic techniques , method of pancreatic stent placement, operative time and introperative blood loss .2. postoperative treatment measures : application of Somatostatin , application of human serum albumin and early enteral nutrition . Results: Of the 135 patients undergoing pancreaticoduodenectomy at the first affiliated Hospital of Medcial College of nanchang University, Overall operative mortality was 3.7%(5/135), and major morbidity was 14.1% (19/l35),including abdominal infection 2, delayed gastric emptying 10, pancreatic leakage 6, lung infection 8, urinary infection 1, postoperative wound infection .2 .the patients with pancreatic leakage were treated conservatively ,except for one died of pancreatic leakage and one cured by operation again .Statistical analysis showed that there is correlation between introperative blood loss and Postoperative pancreatic leakage(P<0.05),while there is no correlation between Postoperative pancreatic leakage and the factors ,such as operative technique ( removal range) , pancreatic anastomotic techniques , method of pancreatic stent placement, operative time (P>0.05); there is correlation that application of somatostatin , human serum albumin and early enteral nutrition can prevent postoperative pancreatic leakage(P<0.05).Conclusions: Pancreatic leakage occurred commonly postoperativly ,which there is the correlation between occurrence of pancreatic leakage and the different clinical treatment measures given intraoperative and postoperative . It is important methods for preventing or reducing the occurrence of pancreatic leakage that the exquisitely surgical technique intraoperative and rationally adoption of treatment measures postoperative are .