Risk factors for postoperative pancreatic fistula in distal pancreatectomy.

Abstract

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.

• Authors: Koji Soga, Toshiya Ochiai, Teruhisa Sonoyama, Koji Inoue, Hisashi Ikoma, Shojiro Kikuchi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 2011 Jul-Aug Vol. 58 Issue 109 Pg. 1372-6 ISSN: 0172-6390 [Print] Greece
• PMID: 21937410 (Publication Type: Journal Article)

Chemical References

• Fibrin Tissue Adhesive
• Polyglycolic Acid
• Polyethylene Glycols

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Fibrin Tissue Adhesive
• Humans
• Male
• Middle Aged
• Pancreatectomy (adverse effects)
• Pancreatic Fistula (etiology)
• Polyethylene Glycols (administration & dosage)
• Polyglycolic Acid (administration & dosage)
• Postoperative Complications (etiology)
• Risk Factors
• Surgical Mesh