Analysis of risk factors for pancreatic fistula after pancreaticoduodenectomy

Objective: To explore the risk factors for pancreatic fistula after pancreaticoduodenectomy( PD). Methods: The clinical data of 158 patients receiving PD in the First Affiliated Hospital of Zhengzhou University between June 2008 and June 2013 were studied. And the potential perioperative factors for pancreatic fistula were analyzed with univariate and multivariate logistic regression model. Results: The incidence of postoperative pancreatic fistula was 9. 5%( 15 /158) in the group of patients,and the mortality associated with pancreatic fistula was 13. 3%. Univariate analysis showed that BMI,pancreatic texture and the different anastomosis patterns were associated with postoperative pancreatic fistula( P 0. 05). Multivariate analysis announced that BMI 25( OR =4.670),soft pancreas( OR =6.035),interrupted suture( OR =3.607) were independent risk factors for postoperative pancreatic fistula. Conclusion: BMI 25,soft pancreas,interrupted suture predict a high probability of pancreatic fistula after PD. Effective preoperative evaluation,surgeon with rich experience and using appropriate pancreaticojejunostomy is the efficient path for reducing the incidence of postoperative pancreatic fistula.