title: Risk factors for postoperative pancreatic fistula in distal pancreatectomy.
abstract: OBJECTIVE
  The purpose of this study was to identify risk factors related to severe pancreatic fistula in patients who underwent distal pancreatectomy (DP).
  
  
  METHODS
  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.affiliation: Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Soga
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sonoyama
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Shojiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015718:Fibrin Tissue Adhesive; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology*; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011100:Polyglycolic Acid / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D013526:Surgical Mesh
chemical_list: D015718:Fibrin Tissue Adhesive; D011100:Polyglycolic Acid; D011092:Polyethylene Glycols