Substantial atherosclerotic celiac axis stenosis is a new risk factor for biliary fistula after pancreaticoduodenectomy.
In: International Journal of Surgery, Jg. 49 (2018), S. 62-67
Online
academicJournal
Zugriff:
Background: Biliary fistula (BF) is a major surgical complication that can develop after pancreaticoduodenectomy (PD) whose risk factors remain unclear. Substantial atherosclerotic celiac axis stenosis (SACAS) has not been reported to be one of them. Methods: Data from 507 patients undergoing PD between Jan 1, 2013 and Dec 31, 2015 were retrospectively collected. Clinical data from patients with SACAS were studied, and the independent risk factors for BF underwent multivariate logistic regression analysis, including SACAS. Results: BF occurred in 22 (4.3%) patients, and the incidence of BF was significantly higher in patients with SACAS than in those without it (27.0% vs 2.6%, P < .001). In the univariate analysis, BF was significantly related to SACAS, older age, a higher ASA score, history of coronary disease, greater blood loss and RBC transfusion during surgery, smaller CBD diameter and higher POD 1 BUN level. The multivariate analysis showed that only SACAS (OR 8.91, 95% CI 2.36-33.69, P = .001), older age (OR 1.08, 95% CI 1.01-1.15, P = .028) and smaller preoperative CBD (OR 0.79, 95% CI 0.69-0.92, P = .002) were independent risk factors for postoperative BF. Conclusion: Older age and a smaller preoperative CBD diameter are independent risk factors for BF after PD, which is consistent with the literature. In addition, SACAS is a new independent risk factor for BF. For patients with SACAS, postoperative drainage should be carefully managed to precisely observe the potential for BF. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Surgery is the property of Wolters Kluwer Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Substantial atherosclerotic celiac axis stenosis is a new risk factor for biliary fistula after pancreaticoduodenectomy.
|
---|---|
Autor/in / Beteiligte Person: | Zhou, Yiran ; Wang, Wei ; Shi, Yusheng ; Lu, Xiongxiong ; Zhan, Qian ; Chen, Hao ; Deng, Xiaxing ; Peng, Chenghong ; Shen, Baiyong |
Link: | |
Zeitschrift: | International Journal of Surgery, Jg. 49 (2018), S. 62-67 |
Veröffentlichung: | 2018 |
Medientyp: | academicJournal |
ISSN: | 1743-9191 (print) |
DOI: | 10.1016/j.ijsu.2017.11.054 |
Schlagwort: |
|
Sonstiges: |
|