title: Retrospective analysis of risk factors affecting pacreatic fistula formation after the closure of the pancreatic stump with sutures in distal pancreatectomy.
abstract: OBJECTIVE
  Development of pancreatic fistula after distal pancreatectomy is still a major problem. Various methods have been defined to prevent the development of the fistula. In this study, the results of suture closure of pancreatic duct and closure of pancreatic stump with “U” sutures passing through each other and the risk factors affecting the development of fistula are studied.
  
  
  METHODS
  Fifty-one patients with prospectively collected data were included in the study. In all patients, pancreatic stump was closed with the same surgical technique. Risk factors that may affect fistula formation were studied between groups with and without fistula. Pancreatic fistula definition was made according to the International Study Group on Pancreatic Fistulas classification.
  
  
  RESULTS
  Eight (15.7%) of the 51 patients had fistula. Clinically significant fistula ratio was 9.8% (according to ISGPF B and C). Additional organ resections were performed in 18 patients (35.3%). In multivariate analysis, the soft texture of pancreatic parenchyma (OR: 12.420, p = 0.048) and over 150 mL of blood loss (OR: 1.003, p = 0.043) were found as risk factors for the development of fistula.
  
  
  CONCLUSIONS
  Closure of pancreatic stump after distal pancreatectomy with “U” shaped sutures passing through each other is a method that can be performed safely.
authors.forename: Tarkan
authors.initials: T
authors.lastname: Unek
authors.forename: Tufan
authors.initials: T
authors.lastname: Egeli
authors.forename: Mucahit
authors.initials: M
authors.lastname: Ozbilgin
authors.forename: Naciye Cigdem
authors.initials: NC
authors.lastname: Arslan
authors.forename: Huseyin
authors.initials: H
authors.lastname: Astarcioglu
authors.forename: Sedat
authors.initials: S
authors.lastname: Karademir
authors.forename: Gulsen
authors.initials: G
authors.lastname: Atasoy
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Astarcioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010180:Pancreatectomy / Q000009:adverse effects*; D010183:Pancreatic Ducts / Q000601:surgery*; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult