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- W4382807118 abstract "Pancreatic fistula remains the most dangerous complication after pancreatoduodenectomy. This study aimed to identify the operative risk factors for clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy. This was a prospective multicenter cohort study that investigated the association between clinically relevant postoperative pancreatic fistula and operative risk factors in 107 patients who underwent pancreatoduodenectomy at three tertiary centers from August 2017 to July 2022. The incidence of the clinically relevant postoperative pancreatic fistula was 26.2%. With univariate analysis, soft pancreatic texture (OR 7.304, 95% CI 2.732-19.531, P < 0.0001), small main pancreatic duct diameter (OR 4.645, 95% CI 1.766-12.221, P < 0.001), right-sided pancreatic transection (OR 4.560, 95% CI 1.810-11.488, P < 0.001), absorbable suture (OR 2.509, 95% CI 1.027-6.128, P = 0.040), pancreatico-enteric anastomosis invagination technique (OR 0.352, 95% CI 0.139-0.894, P = 0.025), non-stented pancreatic drainage (OR 0.234, 95% CI 0.094-0.581, P < 0.001), internal pancreatic drainage (OR 8.333, 95% CI 2.025-34.286, P < 0.001), long anastomotic time (OR 0.336, 95% CI 0.138-0.818, P < 0.014), and R1 resection margin (OR 0.339, 95% CI 0.134-0.857, P < 0.019) were risk factors for clinically relevant postoperative pancreatic fistula. Multivariate analysis identified four independent risk factors for clinically relevant postoperative pancreatic fistula: (1) soft pancreatic texture (OR 0.219, 95% CI 0.061-0.792, P = 0.021), (2) small main pancreatic duct diameter (OR 0.280, 95% CI 0.086-0.910, P = 0.034), (3) right-sided pancreatic transection (OR 0.168, 95% CI 0.032-0.881, P = 0.035), and (4) non-stented pancreatic drainage (OR 3.771, 95% CI 1.147-12.401, P = 0.029). The incidence of the clinically relevant postoperative pancreatic fistula is reduced significantly by left-sided pancreatic transection and pancreatic drainage. Soft pancreatic texture and small main pancreatic duct diameter are independent risk factors for clinically relevant postoperative pancreatic fistula." @default.
- W4382807118 created "2023-07-02" @default.
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- W4382807118 date "2023-06-01" @default.
- W4382807118 modified "2023-09-27" @default.
- W4382807118 title "P-103 Operative risk factors for clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A prospective multicenter cohort study" @default.
- W4382807118 doi "https://doi.org/10.1016/j.annonc.2023.04.159" @default.
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