Analysis of risk factors for pancreatic fistula after distal pancreatectomy
Objective: To identify the factors associated with the occurrence of pancreatic fistula after distal pancreatectomy. Methods: The clinical data of 100 patients who underwent distal pancreatectomy from February 2010 to May 2016 were reviewed. The relevant factors were analyzed by univariate and multivariate analyses. Results: Among the 100 patients, postoperative pancreatic fistula occurred in 32 cases (32%), with grade A pancreatic fistula (without clinical impact) in 18 cases (18%), and clinically significant pancreatic fistula in 14 cases (14%), compromising grade B pancreatic fistula in 8 cases and grade C pancreatic fistula in 6 cases. In univariate analysis, the high body mass index (≥25 kg/m2) was significantly associated with the occurrence of overall postoperative pancreatic fistula (χ2=4.128, P=0.042), but not with the occurrence of clinically significant postoperative pancreatic fistula (χ2=1.545, P=0.214), while soft pancreatic texture was significantly associated with the occurrence of both overall and clinically significant postoperative pancreatic fistula (χ2=4.569, P=0.033; χ2=11.374, P=0.001). Multivariate analysis showed that soft pancreatic texture was unique independent risk for the occurrence of overall or clinically significant postoperative pancreatic fistula (OR=2.476, P=0.043; OR=8.012, P=0.003). Conclusion: Pancreatic texture is an important influential factor for the occurrence of postoperative pancreatic fistula, and aggressive control measures should be adopted in those with soft pancreatic texture.