title: Risk factors for postoperative pancreatic fistula after laparoscopic distal pancreatectomy using stapler closure technique from one single surgeon.
abstract: Laparoscopic distal pancreatectomy (LDP) is a safe and reliable treatment for tumors in the body and tail of the pancreas. Postoperative pancreatic fistula (POPF) is a common complication of pancreatic surgery. Despite improvement in mortality, the rate of POPF still remains high and unsolved. To identify risk factors for POPF after laparoscopic distal pancreatectomy, clinicopathological variables on 120 patients who underwent LDP with stapler closure were retrospectively analyzed. Univariate and multivariate analyses were performed to identify risk factors for POPF. The rate of overall and clinically significant POPF was 30.8% and13.3%, respectively. Higher BMI (≥25kg/m2) (p-value = 0.025) and longer operative time (p-value = 0.021) were associated with overall POPF but not clinically significant POPF. Soft parenchymal texture was significantly associated with both overall (p-value = 0.012) and clinically significant POPF (p-value = 0.000). In multivariable analyses, parenchymal texture (OR, 2.933, P-value = 0.011) and operative time (OR, 1.008, P-value = 0.022) were risk factors for overall POPF. Parenchymal texture was an independent predictive factor for clinically significant POPF (OR, 7.400, P-value = 0.001).
authors.affiliation: Department of Surgery, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xia
authors.affiliation: Department of Surgery, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Ren-Chao
authors.initials: RC
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Zhou
authors.affiliation: Department of Surgery, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Rong-Gao
authors.initials: RG
authors.lastname: Chen
authors.affiliation: Department of Surgery, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Chao-Jie
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000175:diagnosis* / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D055815:Young Adult