Preoperative CT anthropometric measurements and pancreatic pathology increase risk for postoperative pancreatic fistula in patients following pancreaticoduodenectomy

• Published in: PloS one 2020-12, Vol.15 (12), p.e0243515-e0243515
• Main Authors: Roh, Yun Hwa, Kang, Bo Kyeong, Song, Soon-Young, Lee, Chul-Min, Jung, Yun Kyung, Kim, Mimi
• Format: Article
• Language: English
• Subjects: Abdomen; Adenocarcinoma; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Biology and Life Sciences; Blood transfusions; Body mass index; Body measurements; Cancer; Complications and side effects; Confidence intervals; Development and progression; Diagnosis; Female; Fistula; Fistulae; Fistulas; Humans; Logistic Models; Male; Medical schools; Medicine; Medicine and Health Sciences; Middle Aged; Multivariate analysis; Musculoskeletal system; Obesity; Odds Ratio; Pancreas; Pancreas - surgery; Pancreatectomy - adverse effects; Pancreatic Ducts - pathology; Pancreatic Fistula - diagnosis; Pancreatic Fistula - etiology; Pancreatic Fistula - physiopathology; Pancreatic Neoplasms; Pancreatic Neoplasms - pathology; Pancreaticoduodenectomy; Pancreaticoduodenectomy - adverse effects; Pancreaticoduodenectomy - methods; Pancreaticoduodenectomy - mortality; Pancreatitis; Pancreatitis - etiology; Pathology; Patients; Postoperative complications; Postoperative Complications - etiology; Postoperative Period; Regression analysis; Retrospective Studies; Risk analysis; Risk Assessment; Risk Factors; Sarcopenia; Surgery; Surgical outcomes; Tomography, X-Ray Computed - adverse effects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0243515

Postoperative pancreatic fistula (POPF) is a common complication following pancreaticoduodenectomy (PD). However, risk factors for this complication remain controversial. We conducted a retrospective analysis of 107 patients who underwent PD. POPF was diagnosed in strict accordance with the definition of the 2016 update of pancreatic fistula from the International Study Group on Pancreatic Fistula (ISGPF). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for POPF. A total of 19 (17.8%) subjects of pancreatic fistula occurred after PD, including 15 (14.1%) with grade B POPF and 4 (3.7%) with grade C POPF. There were 33 (30.8%) patients with biochemical leak. Risk factors for POPF (grade B and C) were larger area of visceral fat (odds ratio [OR], 1.40; p = 0.040) and pathology other than pancreatic adenocarcinoma or pancreatitis (OR, 12.45; p = 0.017) in the multivariate regression analysis. This result could assist the surgeon to identify patients at a high risk of developing POPF.