Impact of possible risk factors on pancreatic fistula development after pancreaticoduodenectomy: Prospective cohort study
Keywords:Pancreatic fistula, Pancreaticoduodenectomy, Pancreaticoenteric anastomosis
Aim: The most important complication that develops after pancreaticoduodenectomy is anastomosis leak and pancreatic fistula. Pancreatic fistula is thought to be the cause of major complications such as intra-abdominal abscess. The relationship between the development of fistula after pancreaticoduodenectomy and intraoperative risk factors (resection type, pancreatic anastomosis type, pancreatic duct diameter and pancreatic stump structure), along with the effect of pancreatic fistula on morbidity were investigated.
Methods: Forty-one patients who had undergone pancreaticoduodenectomy due to periampullary region tumors were included in this study. Patients were divided into two groups as with and without pancreatic fistula, and compared in terms of demographics, preoperative serum bilirubin and serum albumin values, and intraoperative risks (resection type, pancreatic anastomosis type, pancreatic duct diameter and pancreatic stump structure). In addition, the groups were evaluated for the development of post-operative complications.
Results: When both groups were compared in terms of intraoperative risk factors (resection type, pancreatic anastomosis type, pancreatic duct diameter and pancreatic stump structure), similar results were obtained for biochemical parameters (P=0.719, 0.599, 0.250, 0.906, respectively). A statistically significant association was found between the occurrence of pancreatic fistula and delay of gastric emptying (P=0.028). No significant relationship was detected between intraabdominal collection-abscess, intraabdominal hemorrhage, wound infection parameters and pancreatic fistula (P=0.204, 0.950, 0.116, respectively).
Conclusion: No factors were found to be solely associated with the development of pancreatic fistula following pancreaticoduodenectomy; however, it was concluded that pancreaticoenteric anastomosis technique and the consistency of pancreatic stump may be closely and significantly related.
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