Risk factors of developing pancreatic fistula in patients after laparoscopic distal pancreatectomy / 中华肝胆外科杂志

ABSTRACT

Objective:To study the factors related to development of pancreatic fistula after laparoscopic distal pancreatectomy.Methods:The clinical data of all patients who underwent laparoscopic distal pancreatectomy at the Second Hospital of Hebei Medical University from January 2019 to December 2020 were retrospectively analyzed. Gender, age, intraoperative blood loss, treatment of pancreatic stump, body mass index (BMI), pancreatic texture, albumin and other indicators were analyzed between patients with and without pancreatic fistula. Logistic regression analysis was used to determine independent risk factors for pancreatic fistula.Results:Of 93 patients in this study, there were 33 males and 60 females, mean age (49.23±15.62), range 16 to 76 years. The incidence of postoperative pancreatic fistula was 34.4% (32/93). On univariate analysis, BMI (χ 2=4.515, P=0.034), pancreatic texture (χ 2=3.891, P=0.049), preoperative serum albumin ( t=2.644, P=0.010) and albumin difference ( t=-2.293, P=0.024) were significantly associated with postoperative pancreatic fistula. Multivariate logistic regression analysis showed that low preoperative albumin ( OR=0.551, P<0.001), large difference in albumin ( OR=1.542, P<0.001), BMI≥25 kg/m 2 ( OR=3.303, P=0.035) and soft pancreatic texture ( OR=3.065, P=0.049) were independent risk factors for pancreatic fistula. Conclusion:For patients with BMI≥25 kg/m 2 and patients with a soft pancreas, there was a higher chance to develop pancreatic fistula after operation.