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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Surgery 1/2015

Risk factors and outcomes of postoperative pancreatic fistula after pancreatico-duodenectomy: an audit of 532 consecutive cases

BMC Surgery > Ausgabe 1/2015
Shun-Jun Fu, Shun-Li Shen, Shao-Qiang Li, Wen-Jie Hu, Yun-Peng Hua, Ming Kuang, Li-Jian Liang, Bao-Gang Peng
Wichtige Hinweise
Shun-Jun Fu and Shun-Li Shen contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SJF, SLS and BGP were the main authors of the manuscript. They were involved in the conception, design and coordination of the study as well as in data analysis, interpretation of results and drafting the manuscript. BGP was in charge of all experimental procedures. SQL, WJH, YPH, MK and LJL participated in the experimental procedures and revised critically the content of the manuscript. All authors contributed to the interpretation of data and critically revised the manuscript. All authors read and approved the final manuscript.



Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes.


We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined.


PF was found in 65 (12.2%) cases, of whom 11 were classified into ISGPF grade A, 42 grade B, and 12 grade C. Clinically serious postoperative complications in the PF versus no PF group were mortality, abdominal bleeding, bile leak, intra-abdominal abscess and pneumonia. Univariate and multivariate analysis showed that blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreaticojejunostomy type were independent risk factors of PF after PD.


Blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreatico-jejunostomy type were independent risk factors of PF after PD. PF was related with higher mortality rate, longer hospital stay, and other complications.
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