Analysis Of Risk Factors Of Pancreatic Fistula After Pancreatoduodenectomy And The Different Postoperative Influence Of Different Drainage Way Of The Pancreatic Duct

Objective:T o investigate the risk factors of pancreatic fistula after pancreaticoduoden-ectomy(PD) and compare the clinical efficacy of internal and external drainage of pancreatic duct stent. Explore effective prevention measures of postoperative pancreat-ic fistula and other complications after PD.Methods:B etween January 2009 and October 2014, the analysis of the clinical data of 62 cases of pancreaticoduodenectomy patients of our hospital was performed in a retrospective fashion. All the patients were divided into pancreatic fistula group and non-pancreatic fistula group.The univariate and multivariate analysis were done for the related factors. The univariate and multivariate analysis were done using the Pearson chi-squared test and non-conditional Logistic regression model. If the conditions do not comply with the chi squared test, Fisher’s exact test was be used. Further to the analysis of related risk factors, we compared the difference of the incidence of anastomotic bleeding and pancreatic fistula between internal and external drainage of the pancreatic duct stent group according to the different drainage of the pancreatic duct.Results:T he total incidence of pancreatic fistula after pancreaticoduodenectomy was 17.7%(11/62). Univariate analysis showed that the 4 factors, being age, postoperative serum albumin, postoperative drainage of the pancreatic duct and somatostatin were significantly related to the development of PD postoperative pancreatic. Multivariate analysis showed that the higher the age and pancreatic duct drainage were independ-ent risk factors of pancreatic fistula after PD operation.There was a significant difference between the intraoperative insertion of a placement of pancreatic duct stent for pancreatic duct drainage and no drainage, with the development of postoperative pancreatic fistula in cases with no stent drainage(p=0.003). Also, there was a significant difference in the incidence of postoperative pancreatic fistula in the group of Pancreatic duct stent tube drainage(4%), compared to internal drainage group(11.8%). Other complications(biliary fistula, intestinal fistula, anastomotic bleeding occurred group contrast etc.) in the external drainage group decreased significantly, and the rate of the internal drainage of the control group is statistically differs significantly.Conclusion:1. The elderly and the drainage of the pancreatic duct are independent risk factors of the development of pancreatic fistula after PD. 2. The placement of pancreatic duct stent tube drainage of pancreatic juice can effectively reduce the incidence of postoperative pancreatic fistula. 3. Pancreatic duct stent tube drainage is more effective in Preventing pancreatic fistula after PD operation when compared with internal drainage and is associated with decreased incidence of postoperative intestinal fistula, biliary fistula, anastomotic bleeding complications.