Liang Ting-Bo, Bai Xue-Li, Zheng Shu-Sen
Department of Hepato-Biliary-Pancreatic Surgery, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, PR China.
Pancreatology. 2007;7(4):325-31. doi: 10.1159/000105498. Epub 2007 Jul 11.
The aim of the study is to validate a new classification of pancreatic fistula (PF) and to document risk factors for PF.
A retrospective study was performed on 100 patients who underwent pancreaticoduodenectomy (PD) within a 2-year period. PF was diagnosed according to the criteria developed by an International Study Group on Pancreatic Fistula (ISGPF). Sixteen pre- and intraoperative risk factors for PF were analyzed.
Of 100 patients 32 developed PF; grade A in 21 patients, grade B in 10, and grade C in 1. Four risk factors including pathological diagnosis, concomitant surgery, diameter of pancreatic duct, and texture of the remnant pancreas were found to be significantly associated with PF by univariate analysis. Texture of the remnant pancreas and concomitant surgery were demonstrated to be independent risk factors by multivariate logistic regression. If a PF occurred, advanced age was found to be a risk factor for PF grade B by univariate analysis, but age was not an independent risk factor by multivariate logistic regression.
The status of the remnant pancreas is identified asa substantial risk factor for PF after PD. When soft remnant pancreas is encountered, more careful handling is required in an attempt to minimize the rate of PF. This study confirms that the ISGPF classification of PF is useful.
本研究旨在验证一种新的胰瘘（PF）分类方法，并记录PF的危险因素。
对2年内接受胰十二指肠切除术（PD）的100例患者进行回顾性研究。根据国际胰瘘研究组（ISGPF）制定的标准诊断PF。分析了16个PF的术前和术中危险因素。
100例患者中32例发生PF；21例为A级，10例为B级，1例为C级。单因素分析发现包括病理诊断、同期手术、胰管直径和残余胰腺质地在内的4个危险因素与PF显著相关。多因素logistic回归显示残余胰腺质地和同期手术是独立危险因素。单因素分析发现，如果发生PF，高龄是PF B级的危险因素，但多因素logistic回归显示年龄不是独立危险因素。
残余胰腺的状况被确定为PD术后PF的一个重要危险因素。当遇到质地柔软的残余胰腺时，需要更谨慎地处理，以尽量降低PF的发生率。本研究证实ISGPF的PF分类是有用的。
