title: Perioperative serum albumin correlates with postoperative pancreatic fistula after pancreaticoduodenectomy.
abstract: OBJECTIVE
  Despite improvements in surgical techniques, instruments and perioperative management, postoperative pancreatic fistula (POPF) remains a serious complication after pancreaticoduodenectomy. The aim of the present study was to characterize a high-risk group for POPF after pancreaticoduodenectomy using perioperative clinical variables of patients.
  
  
  METHODS
  This retrospective study comprised of 247 patients who had undergone pancreaticoduodenectomy between May 2000 and May 2013. Perioperative risk factors pertinent to development of POPF were investigated using univariate and multivariate analyses.
  
  
  RESULTS
  POPF developed in 43 out of 247 patients (17.4 %). In univariate analysis, male gender (p=0.005), higher postoperative serum amylase (p=0.025) and lower postoperative serum albumin (p=0.041) were significant risk factors for POPF. In multivariate analysis, male gender (p=0.008) and lower postoperative serum albumin (p=0.010) were found to be independent risk factors.
  
  
  CONCLUSIONS
  Male gender and postoperative lower serum albumin were associated with the development of POPF after pancreaticoduodenectomy.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan sheetan@jikei.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shirai
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Iwase
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Haruki
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Futagawa
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000097:blood* / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D059035:Perioperative Period; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D012737:Sex Factors
chemical_list: D012709:Serum Albumin
keywords: Postoperative pancreatic fistula; pancreaticoduodenectomy; postoperative serum albumin