Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2016; 22(34): 7797-7805
Published online Sep 14, 2016. doi: 10.3748/wjg.v22.i34.7797
Risk factors for postoperative pancreatic fistula: Analysis of 539 successive cases of pancreaticoduodenectomy
Bing-Yang Hu, Tao Wan, Wen-Zhi Zhang, Jia-Hong Dong
Bing-Yang Hu, Tao Wan, Wen-Zhi Zhang, Jia-Hong Dong, Institute and Hospital of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
Jia-Hong Dong, Hepato-Pancreato-Biliary Center, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
Author contributions: Hu BY and Dong JH contributed equally to this work; Hu BY and Dong JH designed the research; Hu BY collected and analyzed the data and drafted the manuscript; Zhang WZ and Wan T contributed analytical tools; all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Chinese People’s Liberation Army General Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Jia-Hong Dong, Institute and Hospital of Hepatobiliary Surgery, Chinese PLA General Hospital; Hepato-Pancreato-Biliary Center, Beijing Tsinghua Changgung Hospital, 168 Litang Road, Beijing 102218, China. zhangwenzhi301301@163.com
Telephone: +86-10-66938331 Fax: +86-10-68241383
Received: April 17, 2016
Peer-review started: April 18, 2016
First decision: May 12, 2016
Revised: June 28, 2016
Accepted: July 31, 2016
Article in press: August 1, 2016
Published online: September 14, 2016
Processing time: 39 Days and 15.1 Hours
Core Tip

Core tip: Pancreaticoduodenectomy remains the standard surgical approach for tumors involving the lower bile duct, the pancreatic head, the duodenal papilla, and the ampulla. This operation is considered risky because of high rates of postoperative mortality and complications. In this study, we collected a large sample of 539 cases and analyzed several potential risk factors for pancreatic fistula. A statistical analysis of the case data showed that gender (male), pancreatic duct-jejunum double-layer mucosa-to-mucosa pancreaticojejunal anastomosis, pancreatic duct diameter ≤ 3 mm, and soft pancreas were risk factors for pancreatic fistula after pancreaticoduodenectomy.