2017 Volume 32 Issue 2 Pages 155-161
Postoperative pancreatic fistula (PF) is the most common complication after distal pancreatectomy (DP). However, risk factors of PF are still under debate. The aim of this study was to investigate risk factors of clinically relevant PF after DP for pancreatic cancer.
Medical records of 40 patients who underwent DP for pancreatic cancer were retrospectively reviewed. Of the preoperative factors, patients with PF (4/19, 21%) had diabetes mellitus more frequently than those without PF (12/21, 57%, P=0.03). Of the intraoperative factors, resection procedure (hand-sewn or stapled procedure) and operating surgeon (trainee or expert) did not affect PF; however, trainee surgeons (19/19, 100%) resected the pancreas using linear stapler more frequently than expert surgeons (13/21, 62%, P<0.01). Multivariate analysis showed that thickness of the pancreas of ≥ 14mm (odds ratio: 11.6, 95% confidence interval: 1.6-244.1) and absence of preoperative diabetes mellitus (odds ratio: 14.8, 95% confidence interval: 2.2-308.0) were independent factors of PF.
In conclusion, a thick pancreas and the absence of comorbid diabetes mellitus are independent risk factors of PF after DP for pancreatic cancer.
