Abstract：
BACKGROUND:Studies of risk factors after pancreatoduodenectomy are few: some concern restricted populations and others are based on administrative data. METHODS:Multicenter clinical data were collected for 300 patients undergoing pancreatoduodenectomy to determine (by univariate and multivariate analysis) preoperative and intraoperative risk factors for mortality and intra-abdominal complications (IACs), including pancreatic fistula. Fourteen factors including the center and volume effect were analyzed. RESULTS:In univariate analysis, mortality was increased with age 70 years or more, extended resection(s), and volume and center effects. IACs occurred more often with main pancreatic duct diameter of 3 mm or less, normal parenchyma texture, extended resection(s), and the center effect. Pancreatic fistula was more frequent with main pancreatic duct diameter of 3 mm or less, normal parenchyma texture, and the center effect. In multivariate analysis, independent risk factor(s) for mortality were age greater than 70 years (odds ratio [OR], 3; 95% confidence interval [CI], 1.3-8) and extended resection (OR, 5; 95% CI, 1.2-22), risk factors for IACs were extended resection (OR, 5; 95% CI, 1.2-22) and main pancreatic duct diameter of 3 mm or less (OR, 2; 95% CI, 1.1-3), and the risk factor for pancreatic fistula was main pancreatic duct diameter of 3 mm or less (OR, 2.5; 95% CI, 1.2-4.6). CONCLUSIONS:Age more than 70 years, extended resections, and main pancreatic duct diameter less than 3 mm are independent risk factors that should be considered in indications for and techniques of pancreatoduodenectomy.
journal_name
Surgeryjournal_title
Surgeryauthors
Muscari F,Suc B,Kirzin S,Hay JM,Fourtanier G,Fingerhut A,Sastre B,Chipponi J,Fagniez PL,Radovanovic A,French Associations for Surgical Research.doi
10.1016/j.surg.2005.08.012subject
Has Abstractpub_date
2006-05-01 00:00:00pages
591-8issue
5eissn
0039-6060issn
1532-7361pii
S0039-6060(05)00489-7journal_volume
139pub_type
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