Pancreas Institute of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
Sci Rep. 2017 Mar 15;7(1):185. doi: 10.1038/s41598-017-00311-8.
Postoperative pancreatic fistula (POPF) is a common complication following distal pancreatectomy (DP). However, the risk factors of this complication in patients after DP still remain controversial. The aim of our study is to estimate the association between potential risk factors and POPF. Relevant articles published up to June 21, 2016 were identified via PubMed, EMBASE, Web of Science, and The Cochrane Library. Studies that examined the risk factors of POPF following DP were enrolled. 20 articles (2070 patients) were finally included in this study. The pooled data suggested that patients with soft pancreas, higher Body Mass Index (BMI), blood transfusion, elevated intraoperative blood loss, and longer operative time had a decreased risk for POPF. However, age, gender, malignant pathology, types of stump closure, octreotide therapy, history of diabetes and chronic pancreatitis, splenectomy, multiorgan resection, main duct ligation, preoperative serum albumin levels, PGA felt wrapping, and extended lymphadenectomy could not be regarded as risk factors for POPF. Our analytic data demonstrated that pancreas texture, BMI, blood transfusion, intraoperative blood loss, and operative time were clinical predictor for POPF. This study may assist surgeons to screen patients with high risk of POPF and select appropriate treatment measures.
术后胰腺瘘（POPF）是胰体尾切除术（DP）后的常见并发症。然而，DP 后患者发生这种并发症的危险因素仍存在争议。我们的研究旨在评估潜在危险因素与 POPF 之间的关系。通过 PubMed、EMBASE、Web of Science 和 The Cochrane Library 检索至 2016 年 6 月 21 日发表的相关文章。纳入研究 DP 后 POPF 危险因素的文章。最终纳入 20 篇文章（2070 例患者）进行研究。汇总数据表明，胰腺质地软、体质量指数（BMI）高、输血、术中出血量增加和手术时间延长的患者 POPF 风险降低。然而，年龄、性别、恶性病理、残端闭合类型、奥曲肽治疗、糖尿病和慢性胰腺炎病史、脾切除术、多器官切除、主胰管结扎、术前血清白蛋白水平、PGA 感觉包裹和扩大淋巴结清扫术不能作为 POPF 的危险因素。我们的分析数据表明，胰腺质地、BMI、输血、术中出血量和手术时间是 POPF 的临床预测因素。本研究可能有助于外科医生筛选 POPF 高危患者并选择合适的治疗措施。
