title: Risk factors associated with pancreatic fistula after distal pancreatectomy.
abstract: BACKGROUND
  Pancreatic leak (PL) remains a major cause of postoperative morbidity in patients undergoing pancreatic resection.
  
  
  OBJECTIVE
  To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP).
  
  
  METHODS
  35 patients underwent DP during a 10-year period (2000- 2009). Informations regarding diagnosis, operative details, and perioperative morbidity and mortality were collected. Nine risk factors were examined.
  
  
  RESULTS
  Indications for DP included primary pancreatic disease (n=23; 66 %) and non-pancreatic disease (n = 12; 34 %). Postoperative morbidity rate was 43 % and none patient died. No patients required a reoperation. Pancreatic fistula was occurred in 11 patients (31 %). On univariate analysis, incidence of pancreatic fistula rate was not significantly associated with these risk factors: pathology, use of prophylactic octreotide therapy, concomitant splenectomy, additional procedures, intra operative bleeding and texture of pancreatic parenchyma. We observed significant statistical difference between male and female, 47 % of females experienced a pancreatic fistula, while 17 % males developed a pancreatic leakage (p =0.05). The role of the technique of pancreatic stump closure in the development of pancreatic leak remains unclear because of the few number of patients on who we used stapler.
  
  
  CONCLUSIONS
  The rate of pancreatic fistula after left pancreatectomy is 31 %. The female was identified as a risk factor for occurrence of pancreatic fistula after left pancreatectomy. The role implicated in the use of a mechanical claw for the treatment of pancreatic stump requires a larger number of patients to conclude. The body mass index has not been studied in our series.
authors.affiliation: Department of Digestive Surgery, La Rabta Hospital, Tunisia.
authors.forename: Amin
authors.initials: A
authors.lastname: Makni
authors.forename: Wael
authors.initials: W
authors.lastname: Rebai
authors.forename: Amin
authors.initials: A
authors.lastname: Daghfouss
authors.forename: Sofiene
authors.initials: S
authors.lastname: Ayadi
authors.forename: Fadhel
authors.initials: F
authors.lastname: Fterich
authors.forename: Faouzi
authors.initials: F
authors.lastname: Chebbi
authors.forename: Rachid
authors.initials: R
authors.lastname: Ksantini
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jouini
authors.forename: Montassar
authors.initials: M
authors.lastname: Kacem
authors.forename: Zoubeir
authors.initials: Z
authors.lastname: Ben Safta
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult