Multivariate analysis of perioperative risk factors of pancreatic remnant leakage after pancreaticoduodenectomy

ABSTRACT

This study was carried on 24 patients suffering from periampullary carcinoma. All the patients were admitted to Department of Surgery, Main Alexandria University Hospital, and underwent the original Whipple's operation. After Whipple's operation, anastomosis of the pancreatic stump was done by means of pancreaticojejunostomy dunking method, pancreatieo-jejunostomy mueosa to mucosa, pancreatico-gastrostomy implantation method and pancreatico-gastrostomy rnucosa to mucosa method. Each method was done in 6 patients. Leakage occurred in 5 patients [20.8%], 3 [12.5%] of them had leaked after pancreaticojejunostomy dunking method, and the other 2 [8.3%] leaked after panereatieogastrostomy implantation method. After pancreaticojejunostomy dunking method 2 leaking patients died within 30 days of surgery, and the other patient resolved with conservative management. The leaked patients after pancreaticogastrostomy implantation method resolved with conservative management. The incidence of leakage increased with older age, lengthened operative time, increased blood replacement, soft pancreatic texture at the site of cutting and preoperative biliary drainage