511例胰十二指肠切除术患者胰瘘危险因素分析

Risk Factors of pancreatic fistula ： a study on 511 patients after pancreaticoduodenectomy

目的 分析胰十二指肠切除术后患者胰瘘（pancreatic fistual）相关危险因素.方法 回顾解放军总医院2011年1月至2014年2月连续施行的511例胰十二指肠切除术患者的病例资料,采用单因素分析和Logistic回归分析发生胰瘘的可能影响因素.结果 胰十二指肠切除术后胰瘘发生率为48.7％ （249/511）,其中A、B和C级胰瘘发生率分别为11.7％、33.0％、4.0％.单因素分析显示男性、体质量指数（BMI）＞ 25、双层胰肠吻合、血糖≤6.0 mmol/L、胰腺质软是胰十二指肠切除术后胰瘘的危险因素.Logistic回归多因素分析显示男性、BMI＞ 25、胰腺质软是发生胰瘘的独立危险因素.结论 胰十二指肠切除术后发生胰瘘的主要危险因素包括男性、BMI＞ 25、胰腺质软.

Objective To study the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods A retrospective study was conducted on 511 consecutive patients who underwent pancreaticoduodenectomy in our hospital between January 2011 and February 2014.Single factor analysis were used to find out risk factors of pancreatic fistula.Results After pancreaticoduodenectomy,the incidence of pancreatic fistula was 48.7％ （249/511）.The rates of grades A,B and C pancreatic fistula were 11.7％,33.0％ and 4.0％ respectively.On single variable factor analysis,male gender,BMI ＞ 25,double pancreatio-intestinal anastomoses,blood sugar ≤6.0 mmol/L,soft pancreas were risk factors of pancreatic fistula after pancreaticoduodenectomy.On multivariate logistic regression analysis,male gender,BMI ＞ 25,soft pancreas were independent risk factors of pancreatic fistula after pancreaticoduodenectomy.Conclusions Male gender,BMI ＞ 25,soft pancreas were the main factors of pancreatic fistula after pancreaticoduodenectomy.