Department of Surgery, Munich University Medical Center, Germany.
Am J Surg. 2010 Sep;200(3):311-7. doi: 10.1016/j.amjsurg.2009.10.022. Epub 2010 Apr 9.
Pancreatic fistula (PF) represents a major complication after distal pancreatectomy. In a consecutive series of 110 patients, risk factors for the incidence of PF and surgical morbidity were identified.
Patients having undergone distal pancreatectomy between 2003 and 2007 were identified. Clinicopathologic parameters as well as perioperative data were correlated with the incidence of PF and overall surgical morbidity using univariate and multivariate models.
In 72 patients (65%), malignant disease was present. Splenectomy and multivisceral resection were performed in 84 (76%) and 47 (42%) patients, respectively. Overall major surgical morbidity was 18%, and 12 patients (11%) developed PFs. A body mass index > 25 kg/m(2) was the only independent significant predictive factor for PF. Malignancy, splenectomy, multivisceral resection, transfusion, comorbidity, and stapler use did not show statistical significance. For overall surgical morbidity, there was no significant indicator.
A body mass index > 25 kg/m(2) contributes to the incidence of PF after distal pancreatectomy. Other parameters did not show a significant influence on PF or on overall surgical morbidity.
胰瘘（PF）是胰腺远端切除术后的主要并发症。本研究连续纳入 110 例患者，旨在明确 PF 发生的风险因素及手术并发症的发生原因。
回顾性分析 2003 年至 2007 年间接受胰腺远端切除术的患者，应用单因素和多因素模型分析临床病理参数及围手术期数据与 PF 及总体手术并发症发生率的相关性。
72 例（65%）患者为恶性肿瘤，84 例（76%）患者行脾切除术，47 例（42%）患者行联合脏器切除术。总体手术并发症发生率为 18%，12 例（11%）患者发生胰瘘。BMI＞25 kg/m2 是 PF 的唯一独立危险因素。恶性肿瘤、脾切除术、联合脏器切除术、输血、并存疾病及吻合器使用与 PF 或总体手术并发症发生率均无显著相关性。
BMI＞25 kg/m2 是胰腺远端切除术后 PF 发生的危险因素，其他参数与 PF 或总体手术并发症发生率无显著相关性。
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