title: Risk factors and outcomes of postoperative pancreatic fistula after pancreatico-duodenectomy: an audit of 532 consecutive cases.
abstract: BACKGROUND
  Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes.
  
  
  METHODS
  We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined.
  
  
  RESULTS
  PF was found in 65 (12.2%) cases, of whom 11 were classified into ISGPF grade A, 42 grade B, and 12 grade C. Clinically serious postoperative complications in the PF versus no PF group were mortality, abdominal bleeding, bile leak, intra-abdominal abscess and pneumonia. Univariate and multivariate analysis showed that blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreaticojejunostomy type were independent risk factors of PF after PD.
  
  
  CONCLUSIONS
  Blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreatico-jejunostomy type were independent risk factors of PF after PD. PF was related with higher mortality rate, longer hospital stay, and other complications.
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.|Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of TCM), Guangzhou, 510120, P.R. China.
authors.forename: Shun-Jun
authors.initials: SJ
authors.lastname: Fu
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Shun-Li
authors.initials: SL
authors.lastname: Shen
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Shao-Qiang
authors.initials: SQ
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Hu
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Hua
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Ming
authors.initials: M
authors.lastname: Kuang
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Li-Jian
authors.initials: LJ
authors.lastname: Liang
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P.R. China. pengbaogang1963@163.com.
authors.forename: Bao-Gang
authors.initials: BG
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010185:Pancreatic Fistula / Q000209:etiology* / Q000401:mortality; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors