Department of Surgery, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.
Pancreas. 2012 Aug;41(6):916-21. doi: 10.1097/MPA.0b013e31823e7705.
Pancreatic fistula or pancreas-related infectious complications are one of the most common surgical complications after pancreatic surgery. The aims of this study were, first, to reveal the risk factors for clinically relevant pancreas-related infectious complications and, second, to identify those risk factors that are obtainable within the first 3 postoperative days.
One hundred seven consecutive patients who underwent pancreaticoenteral anastomosis between October 2007 and November 2010 were enrolled.
There were 36 patients with clinical pancreas-related infectious complications among 107 in this series of patients. Univariate and multivariate analyses revealed that a narrow main pancreatic duct diameter (<3 mm) was an independent risk factor for clinically relevant pancreas-related infectious complication. Univariate and multivariate analyses also revealed that a body temperature of 38°C or higher on postoperative day 3 (POD3), a leukocyte count of 9.8 × 10(9)/L or greater on POD3, and a drain fluid amylase level of 3000 IU/L or higher on POD3 were significant predictive factors for clinically relevant pancreas-related infectious complication for 58 patients with a narrow main pancreatic duct.
In view of the clinical variables obtained on POD3, such as amylase levels in drain effluent, body temperature, and leukocyte count, clinically relevant pancreas-related infections could be predicted well.
胰瘘或胰腺相关感染并发症是胰腺手术后最常见的手术并发症之一。本研究的目的首先是揭示与临床相关的胰腺感染性并发症的危险因素，其次是确定可在术后 3 天内获得的危险因素。
本研究纳入了 2007 年 10 月至 2010 年 11 月期间接受胰肠吻合术的 107 例连续患者。
在这一系列患者中，有 36 例出现临床相关胰腺感染并发症。单因素和多因素分析显示，主胰管直径狭窄（<3mm）是与临床相关胰腺感染并发症的独立危险因素。单因素和多因素分析还显示，术后第 3 天（POD3）体温≥38°C、白细胞计数≥9.8×10^9/L和引流液淀粉酶水平≥3000IU/L是 58 例主胰管狭窄患者发生与临床相关胰腺感染并发症的显著预测因素。
鉴于 POD3 获得的临床变量，如引流液中的淀粉酶水平、体温和白细胞计数，可以很好地预测与临床相关的胰腺感染。
