Risk factors for post-pancreaticoduodenectomy hemorrhage / 中华普通外科杂志

ABSTRACT

Objective:To investigate the independent risk factors of post-pancreaticoduodenectomy hemorrhage (PPH).Methods:The clinical data of 350 patients who underwent pancreaticoduodenectomy at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Chongqing Medical University from Jul 2014 to Oct 2018 were retrospectively analyzed, the chi-square test and Logistic regression were used for univariate and multivariate analysis.Results:Of the 350 cases, PPH occurred in 35, including intra-abdominal hemorrhage in 20 cases, gastrointestinal hemorrhage in 15 cases, the incidence of PPH was 10.0%. Seven of the 35 PPH cases died. Univariate analysis showed that preoperative bilirubin (χ 2=4.162, P=0.041), pancreatic fistula (χ 2=37.451, P=0.000), biliary fistula (χ 2=7.945, P=0.005), and intro-abdominal infection (χ 2=34.577, P=0.000) infection were significantly associated with PPH; multivariate analysis results indicated that pancreatic fistula ( P=0.000, OR=10.426, 95% CI=3.512-30.955), biliary fistula ( P=0.000, OR=15.754, 95% CI=3.500-70.902), and intro-abdominal infection ( P=0.003, OR=4.530, 95% CI=1.644-12.483) were independent risk factors of PPH. Conclusions:Pancreatic fistula, biliary fistula, and intro-abdominal infection are independent risk factors for PPH.