Risk factors for postoperative pancreatic fistula in distal pancreatectomy
Koji Soga1, Toshiya Ochiai, Teruhisa Sonoyama
1Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Background/Aims:
The purpose of this study was to identify risk factors related to severe pancreatic fistula in patients who underwent distal pancreatectomy (DP).
Methodology:
From 2000 to 2008, 63 patients underwent DP. We retrospectively identified the risk factors for Grade B or C postoperative pancreatic fistula (POPF) occurring after DP. POPF was classified according to the International Study Group on Pancreatic Fistula definition.
Results:
Postoperative mortality and morbidity rate were 0% and 61%, respectively. POPF developed in 32 patients (51%); 21 of fistulas were classified as Grade A, nine as Grade B and two as Grade C. The incidence of severe POPF (Grade B or C) was significantly associated with two factors by univariate analyses: polyethylene glycolic acid (PGA) felt with fibrin sealant and blood loss during operation. To clarify the useful manner in DP, multivariate analysis was performed using 5 surgery-related factors. The use of polyethylene glycolic acid felt (PGA) with fibrin sealant and blood loss during operation were the significant factors for severe POPF (p=0.026 and 0.012, respectively).
Conclusions:
Using PGA felt with fibrin sealant for the pancreatic stump could reduce the risk of severe POPF.
