[Analysis of risk factors of stress-related ulcer and gastrointestinal hemorrhage after pancreaticoduodenectomy].
OBJECTIVE
To assess the risk factors of stress-related ulcer and gastrointestinal hemorrhage after pancreaticoduodenectomy.


METHODS
From May 1999 to July 2007, 285 periampullary cancer patients underwent pancreaticoduodenectomy in our hospital. The clinical data, pathological results, type of operation, and postoperative treatment were retrospectively analyzed. Patients with stress-related ulcer and gastrointestinal hemorrhage were selected for risk factor analysis, and other patients were taken as control group.


RESULTS
35 patients (12.3%) developed stress-related ulcer and gastrointestinal hemorrhage following pancreaticoduodenectomy. Pathological examination showed pancreatic cancer in 5 cases, duodenal cancer in 8, common bile duct cancer in 10, ampullary carcinoma in 11, and solid-pseudopapillary tumors in 1. Single variate analysis demonstrated that alcohol, preoperative bilirubin level, operation time, lymph node metastasis, prealbumin decrease after operation and other complication were significantly associated with the stress-related ulcer and gastrointestinal hemorrhage. Logistic regression in multivariate analysis revealed that preoperative bilirubin level, operation time, other complication, prealbumin decrease after surgery were independent risk factors.


CONCLUSIONS
Stress-related ulcer and gastrointestinal hemorrhage are one of the most common complications after pancreaticoduodenectomy. Preoperative bilirubin level, operation time, other complications, and prealbumin decrease after operation are four independently risk factors.
Zhang
Jian-wei
JW
Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhao
Hong
H
Bai
Xiao-feng
XF
Fang
Yi
Y
Wang
Chen-feng
CF
Zhao
Ping
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D014670:Ampulla of Vater; D001663:Bilirubin / Q000097:blood; D003138:Common Bile Duct Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D004379:Duodenal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010437:Peptic Ulcer / Q000209:etiology*; D011228:Prealbumin / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult
D011228:Prealbumin; D001663:Bilirubin