Risk factors of massive bleeding related to pancreatic leak after pancreaticoduodenectomy
Journal
Journal of the American College of Surgeons
Journal Volume
201
Journal Issue
4
Pages
554-559
Date Issued
2005
Author(s)
Abstract
BACKGROUND: Most pancreatic leaks after pancreaticoduodenectomy were initially treated conservatively, and for the most part, they were self-limiting and closed spontaneously. But in a few patients, hemorrhage occurred 1 to 3weeks postoperatively and remained a fatal complication after pancreaticoduodenectomy. STUDY DESIGN: To identify possible risk factors for massive bleeding, the medical records of 402 patients who had pancreaticoduodenectomies were reviewed for leak complications and analyzed for associations between the occurrence of massive bleeding and preoperative, intraoperative, postoperative, and pathologic parameters. RESULTS: In univariate logistic regression analysis, infectious clinical signs (p = 0.021, odds ratio [OR] = 7.06, 95% CI = 1.34, 37.12) and bile in the drainage fluid (p = 0.036, OR = 5.89, 95% CI = 1.13, 30.86) were associated with the risk of developing massive hemorrhage. This combination provided the highest estimate of massive bleeding after pancreatic leak (p = 0.005, OR = 8.57, 95% CI = 1.92, 38.35). CONCLUSIONS: Both infectious clinical signs and bile content in the drainage fluid considerably increase the risk of massive bleeding after pancreatic leak. Close observation of patients with these ominous signs is warranted. ? 2005 by the American College of Surgeons.
SDGs
Other Subjects
adolescent; adult; aged; bile; controlled study; female; human; intraoperative period; logistic regression analysis; major clinical study; male; medical record; pancreas disease; pancreatic leak; pancreaticoduodenectomy; postoperative complication; postoperative hemorrhage; preoperative period; priority journal; review; risk assessment; risk factor; surgical risk
Publisher
Elsevier Inc.
Type
journal article