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World Journal of Surgery
Published in: World Journal of Surgery 12/2020

Open Access 01-12-2020 | Pancreatoduodenostomy | Original Scientific Report

Predictive Factors for Postoperative Pancreatic Fistula—A Swedish Nationwide Register-Based Study

Authors: C. Williamsson, K. Stenvall, J. Wennerblom, R. Andersson, B. Andersson, B. Tingstedt

Published in: World Journal of Surgery | Issue 12/2020

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Abstract

Background

A serious complication after pancreatoduodenectomy (PD) is postoperative pancreatic fistula (POPF). The aim of this study was to analyse the incidence and predictive factors for POPF by using a large nationwide cohort.

Methods

Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients undergoing a PD from 2010 until 30th June 2018 were collected. The material was analysed in two groups, no POPF and clinically relevant (grade B and C) POPF.

Results

A total of 2503 patients underwent PD, of which 245 (10%) developed POPF. Patients with POPF had significantly more overall complications (Clavien Dindo ≥3a, 75% vs. 21%, p < 0.001) and longer hospital stay (median 23 [16–35] vs. 11 [8–15], p < 0.001) than patients without POPF. The risk of POPF was higher with increased BMI (OR 1.08, p < 0.001). Preoperative presence of diabetes (OR 0.52, p = 0.012) and preoperative biliary drainage (OR 0.34, p < 0.001) reduced the risk of POPF. Reconstruction with pancreaticojejunostomy caused a more than two folded increase in POPF compared with pancreaticogastrostomy (OR 2.41, p < 0.001). Weight gain ≥2 kg on postoperative day 1 was also a risk factor (OR 1.76, p < 0.001).

Conclusion

A high BMI, a pancreaticojejunostomy and postoperative weight gain were risk factors for developing POPF. Diabetes or preoperative biliary drainage was protective.
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Metadata
Title
Predictive Factors for Postoperative Pancreatic Fistula—A Swedish Nationwide Register-Based Study
Authors
C. Williamsson
K. Stenvall
J. Wennerblom
R. Andersson
B. Andersson
B. Tingstedt
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 12/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05735-4

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