Analysis Of Factors Related To Pancreatic Fistula After Distal Pancreatectomy

Objective:The incidence of pancreatic fistula is one of the most common complications.The occurrence of pancreatic fistula is not only a threat to the life of patients,but also increases the cost of hospitalization and prolongs the length of stay.Pancreatic leakage related factors have been the focus of discussion at home and abroad.Some conclusions need to be confirmed by further multicenter clinical randomized controlled study.This article hopes to provide a basis for the prevention of postoperative pancreatic fistula by exploring the related factors of pancreatic fistula after pancreatic body and tail surgery.Method:From January 2009 to January 2019,the age and sex ratio,body mass index,preoperative albumin,pancreatic texture and other indexes of patients undergoing pancreatectomy(including laparotomy and laparoscopy)were collected retrospectiv-ely.The correlation between each index and postoperative pancreatic fistula was analyzed by single factor and logistics multiple factors.Results:a total of 85 patients were included in this study.The incidence of postoperative pancreatic fistula was 27.05%(23/85),of which 13 were male and 10 were female,of which 14 were A pancreatic fistula,7 were B pancreatic fistula,2 were C pancreatic fistula.Other complications: incision infection in 3 cases,splenic infarction in 2 cases,peritoneal effusion in 2 cases,gastroparesis in 1 case,total complication rate was36.47%.Perioperative mortality was 0.BMI(χ2=11.842,P=0.001),main pancreatic duct ligation(χ2=3.399,P=0.065),pancreatic texture(χ2=5.049,P=0.025),and preoperative serum albumin(χ2=2.324,P=0.023)were associated with postoperative pancreatic fistula in univariate analysis.low preoperative albumin(OR=0.800,P=0.042)and 25 kg/ ㎡(OR=0.217,P=0.010)were independent risk factors forpancreatic fistula in multivariate analysis.Conclusion:DP incidence of postoperative pancreatic fistula in this study was 27.05%.low preoperative serum albumin and BMI were independent risk factors for pancreatic fistula.for patients with low preoperative protein,the nutritional status should be improved.patients with body mass index(BMI)greater than 25 kg/m2,strengthen drainage tube amylase detection and abdominal examination,such as early treatment of pancreatic fistula found.Patients with soft pancreatic texture should be alert to the occurrence of postoperative pancreatic fistula,in the process of surgical treatment of residual pancreas,should actively find the main pancreatic duct and ligation,can reduce the incidence of pancreatic fistula to a certain extent.