Kawaida Hiromichi, Kono Hiroshi, Watanabe Mitsuaki, Hosomura Naohiro, Amemiya Hidetake, Fujii Hideki
First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
Surg Today. 2018 Jan;48(1):95-100. doi: 10.1007/s00595-017-1554-2. Epub 2017 Jun 9.
Postoperative pancreatic fistula (POPF) is one of the major complications in patients who undergo distal pancreatectomy (DP). Recently, dividing the pancreas by stapler is a commonly performed technique, however, POPF still occurs. Therefore, the purpose of this study was to investigate the risk factors for POPF after DP using a triple-row stapler.
A total of 75 patients underwent DP using a triple-row stapler (Endo GIA™ Reloads with Tri-Staple™ Technology 60 mm; COVIDIEN, North Haven, CT, USA) at Yamanashi University from December 2012 to December 2016. The clinical risk factors for POPF after DP using a triple-row stapler were identified based on univariate and multivariate analyses.
Clinical POPF (ISGPF Grade B and C) was seen in 7 of 75 patients (9.3%). The body mass index (BMI) was significantly higher in the patients with POPF (26.8 ± 0.5 kg/m) compared with the patients without POPF (21.4 ± 0.4 kg/m; a cut-off value; 25.7 kg/m). In addition, the patients with POPF were significantly younger than the patients without POPF (56.4 ± 5.6 vs 67.0 ± 1.5; a cut-off value was 57.0 years old).
BMI and age were found to be significant risk factors for POPF after DP using a triple-row stapler.
术后胰瘘（POPF）是接受胰体尾切除术（DP）患者的主要并发症之一。近来，使用吻合器离断胰腺是一种常用技术，但POPF仍有发生。因此，本研究旨在探讨使用三排吻合器行DP术后发生POPF的危险因素。
2012年12月至2016年12月，共有75例患者在山梨大学使用三排吻合器（美国科惠医疗公司生产的Endo GIA™ Reloads with Tri-Staple™ Technology 60 mm）行DP。基于单因素和多因素分析确定使用三排吻合器行DP术后发生POPF的临床危险因素。
75例患者中有7例（9.3%）出现临床POPF（国际胰腺外科研究组B级和C级）。发生POPF的患者其体重指数（BMI）显著高于未发生POPF的患者（26.8±0.5kg/m²）（未发生POPF的患者为21.4±0.4kg/m²；临界值为25.7kg/m²）。此外，发生POPF的患者明显比未发生POPF的患者年轻（56.4±5.6岁对67.0±1.5岁；临界值为57.0岁）。
发现BMI和年龄是使用三排吻合器行DP术后发生POPF的重要危险因素。
