临床肝胆病杂志2017，Vol.33Issue(1)：116-120,5.DOI:10.3969/j.issn.1001-5256.2017.01.025
胰十二指肠切除术后胰瘘发生的危险因素分析
Risk factors for pancreatic fistula after pancreaticoduodenectomy
摘要
Abstract
Objective To investigate the risk factors for pancreatic fistula after pancreaticoduodenectomy (PD),and to provide a reference for the prevention and treatment of pancreatic fistula after PD in clinical treatment.Methods A retrospective analysis was performed for the clinical data of 75 patients who underwent PD in Huadong Hospital,Fudan University from January 2014 to December 2015.The influencing factors for pancreatic fistula were analyzed,and the incidence rate of pancreatic fistula was compared between patients undergoing laparo-scopic or open PD.The chi -square test or Fisher′s exact test was used for univariate analysis,and the logistic regression model was used for multivariate analysis.Results Of all patients,21 (28%)had pancreatic fistula,among whom 7 had grade A pancreatic fistula,11 had grade B pancreatic fistula,and 3 had grade C pancreatic fistula.The univariate analysis showed that age,presence or absence of pancreatic duct dilatation,and amylase level in drainage fluid on day 1 after surgery were influencing factors for pancreatic fistula after surgery (χ2 =6.868,12.990,and 4.383,P =0.009,P <0.001,and P =0.004).The multivariate analysis showed that age ≥65 years (95%CI:2.551 -187.550,P =0.005)and absence of pancreatic duct dilatation (95%CI:5.210 -487.321,P =0.001)were risk factors for pan-creatic fistula after surgery.An amylase level of ≥5000 IU /L in drainage fluid on day 1 after surgery had a certain predictive value for the development of pancreatic fistula after surgery.There was no significant difference in the incidence rate of pancreatic fistula between patients undergoing laparoscopic or open PD (18.8% vs 30.5%,P >0.05).Conclusion As for patients with an age of ≥65 years,absence of pancreatic duct dilatation,and an amylase level of ≥5000 IU /L in drainage fluid on day 1 after surgery,treatment should be given as soon as possible to avoid the development of pancreatic fistula.关键词
胰十二指肠切除术/胰腺瘘/危险因素Key words
pancreaticoduodenectomy/pancreatic fistula/risk factors分类
医药卫生引用本文复制引用
王小龙,涂彦渊,王巍,袁祖荣,唐健雄,唐文皓,王伟艺..胰十二指肠切除术后胰瘘发生的危险因素分析[J].临床肝胆病杂志,2017,33(1):116-120,5.基金项目
国家自然科学基金青年科学基金项目 （）
