title: Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients.
abstract: The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785-25.792;P= 0.005), history of abdominal surgery (OR = 5.009; 95% CI: 1.968-12.749;P= 0.001), and preoperative albumin levels (OR = 4.863; 95% CI: 1.962-12.005;P= 0.001). Independent risk factors of late PPH included postoperative pancreatic leakage (OR = 4.696; 95% CI: 1.605-13.740;P= 0.005), postoperative biliary fistula (OR = 6.096; 95% CI: 1.575-23.598;P= 0.009), postoperative abdominal infection (OR = 4.605; 95% CI: 1.108-19.144;P= 0.036), revascularization (OR = 9.943; 95% CI: 1.900-52.042;P= 0.007), history of abdominal surgery (OR = 8.790; 95% CI: 2.779-27.806;P< 0.001), and preoperative albumin levels (OR = 5.563; 95% CI: 1.845-16.776;P= 0.002).
authors.affiliation: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jilin University, Changchun 130000, China; Department of General Surgery, Heilongjiang Province Hospital, Harbin 150000, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China; Department of General Surgery, Heilongjiang Province Land Reclamation Headquarters General Hospital, Harbin 150000, China.
authors.forename: Shengwei
authors.initials: S
authors.lastname: Quan
authors.affiliation: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.
authors.forename: Fujun
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.
authors.forename: Donglai
authors.initials: D
authors.lastname: Ma
authors.affiliation: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.
authors.forename: Lei
authors.identifier: 0000-0002-8701-1911
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jilin University, Changchun 130000, China.
authors.forename: Ping
authors.identifier: 0000-0003-4944-2937
authors.initials: P
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D055815:Young Adult