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. 2010 Jan;34(1):121-5.
doi: 10.1007/s00268-009-0300-3.

Risk factors for clinical pancreatic fistula after distal pancreatectomy: analysis of consecutive 100 patients

Ryuji Yoshioka  1 , Akio Saiura, Rintaro Koga, Makoto Seki, Yoji Kishi, Ryo Morimura, Junji Yamamoto, Toshiharu Yamaguchi
Affiliations

Risk factors for clinical pancreatic fistula after distal pancreatectomy: analysis of consecutive 100 patients

Ryuji Yoshioka et al. World J Surg. 2010 Jan.

Abstract

Background: The mortality associated with distal pancreatectomy (DP) has declined to <5% in recent years in high-volume centers. However, morbidity remains high, ranging from 32% to 57%. Pancreatic fistula (PF) is the most common complication after DP. The aim of this study was to analyze factors associated with the occurrence of clinical PF.

Methods: A retrospective review was performed of the medical records of 100 patients who underwent DP in our institution between May 2001 and January 2009.

Results: There was no mortality, but morbidity was occurred in 65 patients (65%), with major complications occurring in 9 patients (9%). PF occurred in 50 patients (50%) and clinical PF occurred in 23 patients (23%). Multivariate analysis indicated that independent risk factors for clinical PF were: age younger than 65 years (P = 0.049; odds ratio (OR) 2.958; 95% confidence interval (CI) 1.007-8.688), not ligating the main pancreatic duct (MPD) (P = 0.02; OR 4.933; 95% CI 1.283-18.967), and extended lymphadenectomy (P = 0.008; OR 4.773; 95% CI 1.504-15.145).

Conclusions: Age < 65 years, not ligating the MPD, and extended lymphadenectomy are independent risk factors for clinical PF.

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