Risk factors for pancreatic fistula after pancreaticoduodenectomy

Objective To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy. Methods Clinical data of 351 patients who underwent pancreaticoduodenectomy in our hospital from Jan 2001 to Dec 2015 were retrospectively analyzed. Results The overall incidence of pancreatic fistula was 20.2% (71/351), with grade A in 34 (9.7%) patients, grade B in 25 (7.1%), and grade C in 12 (3.4%). Postoperative hospital stay was significantly prolonged in patients with grade B and C pancreatic fistula. Multivariate analysis using Logistic regression identified three variables as independent factors associated with pancreatic fistula, namely, BMI (OR=2.281), preoperative total bilirubin level (OR=2.180) and soft pancreatic texture (OR=3.653). Preoperative total bilirubin level (OR=2.684), soft pancreatic texture (OR=5.128) and postoperative hemorrhage (OR=9.030) were independent risk factors of grade B and C pancreatic fistula after pancreaticoduodenectomy. Conclusions The incidence of pancreatic fistula after pancreaticoduodenectomy is still high. Pancreatic fistula prolongs the postoperative hospital stay significantly. The incidence of grade B and C pancreatic fistula could be reduced by avoiding postoperative hemorrhage. Key words: Pancreaticoduodenectomy; Pancreatic fistula; Risk factors