Risk Factors For Clinical Pancreatic Fistula After Distal Pancreatectomy

Objective: The aim of the current study is to summarize the clinical characters of thepatients and to analyze the factors which may affect the risk of clinical pancreaticfistula formation.Methods: The clinical datas of45DP cases in the First Affiliated hospital of FujianMedical University from January2011to December2013were analyzedretrospectively. The data include gender, age, BMI, preoperative complications,operation method, operation time, intraoperative blood loss, drainage tube pull outtime, postoperative complications, and postoperative hospital stay, postoperativepathological results, etc. The risk factors for clinical pancreatic fistula were analyzed.Results: POPF by International Study Group of Pancreatic Fistula criteria occurred in10patients (22.2%)，and clinical PF in9patients（20%）. On univariate analysis,multivisceral resection (P=0.048) and thickness of pancreas (P=0.001) wereassociated with higher clinical pancreatic fistula rates. On multivariate analysis, onlythe thickness of pancreas>14.5mm (P=0.048，OR=9.344，95%CI1.021-85.525) wasindependently associated with clinical pancreatic fistula formation.Conclusions: Multivisceral resection and thickness of pancreas are associated withhigher clinical pancreatic fistula rates. The thickness of pancreas is a independent riskfactor for clinical PF. For a thick pancreas, POPF is associated with the closure ofpancreatic stump.Dividing a thick pancreas by white (2.5mm/1.0mm) staplecartridges can decrease the rate of postoperative pancreatic fistula.