Risk factors of early removal of abdominal drainage tube after pancreaticoduodenectomy on pancreatic fistula and postoperative pancreatic fistula

Objective To explore the effect of early removal of abdominal drainage tube on pancreatic fistula after pancreaticoduodenectomy (PD) and to analyze the risk factors of postoperative pancreatic fistula. Method 81 patients taking PD at our hospital from July, 2014 to July, 2017 were selected as study objects. No pancreatic fistula occurred 5 d after the operation. According to the times of the abdominal drainage tube removal after PD, they were divided into two groups. The abdominal drainage tubes of group A (34 cases) were removed within 5 d after the surgery, while those of group B (47 cases) more than 5 d after the surgery. The postoperative complications were compared between the two groups. In addition, according to whether having pancreatic fistula or not, they were divided into a pancreatic fistula group and a non-pancreatic fistula group. The risk factors associated with postoperative pancreatic fistula were analyzed by single factor and multivariate Logistic regression. Results The incidences of postoperative pancreatic fistula and abdominal infection was significantly lower in group A than in the control group (11.76% vs. 34.04% and 5.88% vs. 23.40%, P<0.05) . Single factor analysis showed that the related factors influencing occurrence of pancreatic fistula after PD were age, pancreas texture, the main pancreatic duct diameter, operation time, intraoperative bleeding volume, the removal time of postoperative abdominal drainage tube, and tumor location. Multivariate Logistic regression analysis showed that the independent risk factors for pancreatic fistula after PD were advanced age, soft pancreatic quality, operation time, and the removal time of peritoneal drainage tube. Conclusions That removes the abdominal drainage tubes of patients with early non-pancreatic fistula within 5 d after PD can effectively reduce the occurrence of pancreatic fistula, abdominal cavity infection, and so on. However, prolonged catheterization increases the risk of postoperative pancreatic fistula. Key words: Pancreatoduodenectomy; Abdominal drainage; Pancreatic fistula; Abdominal cavity infection