Risk factors of short-term complications after pancreaticoduodenectomy treated periampullary carcinomas
Tóm tắt
Introduction: Pancreaticoduodenectomy has been a radical treatment for periampullary carcinoma, which is a collection of malignant neoplasia of the periampullary region. Although the mortality has declined dramatically, the complications are still high. This study aims to determine the occurring rate of short-term complications after pancreaticoduodenectomy and to identify the risk factors related to those complications. Comprehension of these problems help increase the outcome.
Materials and Method: It is a cross-sectional study of the patients with periampullary cancer, who undergo pancreaticoduodenectomy at Cho Ray Hospital from January 2012 to October 2016.
Results: Overall complication rate was 25.65% from 230 patients. In which, pancreatic fistula and surgical site infection were the two most frequent complication (10.43% and 4.38% respectively). Pancreatic fistula was highly significantly associated with Wirsung’s duct diameter less than 3 mm (p = 0.015) and soften pancreatic parenchyma (p = 0.004). The soften pancreatic parenchyma also increased the risk of surgical site infection (OR 4.588), but it was not statistically significant (p = 0.056). Soften pancreatic parenchyma increased the haemorrhage complication significantly (p = 0.04) (OR: 10,668, 95% confidence).
Discussions: Pancreatic main duct’s diameter, pancreatic density and Hemoglobin may relate to the early postoperative complications following pancreaticoduodenectomy. Detailedly, in particular for pancreatic fistula, 2 risk factors recognized are Wirsung’s diameter less than 3mm and soft pancreatic density. Meanwhile low concentration of hemoglobin in blood may increase the risk of incisional infection. Pancreatic density related to the complication of haemorrhage.
Conclusions: Short-term complications’ rate following pancreatoduodenectomy remains high. Understanding the risk factors help us choose which case should be operated and do pre-operative preparation better.
