Authors
Navmatulya A.Yu.1, Kuznetsov A.I.1, Almukhametova F.R.1, Tsaregorodtsev A.E.1, Bratov O.Z.1, Savchuk S.A.1, Miroshnikov B.I.1, Egorenkov V.V.1, Moiseenko V.M.1, Soloviev I.A.2, Bromberg B.B.3
1 Saint-Petersburg clinical scientific and practical center for specialized types of medical care (oncological), Saint-Petersburg
2 Mariinsky Hospital, Saint-Petersburg
3 S.M. Kirov Military medical academy, St. Petersburg
Abstract
Objective: to study risk factors for the development of pancreatic fistula after pancreatoduodenectomy.
Materials and methods. We studied results of surgical treatment of 108 patients with tumors of the pancreatoduodenal zone, who underwent pancreatoduodenectomy. Based on the results of the treatment, the main risk factors that affect on the frequency of pancreatic fistula formation were identified.
Results. According to the literature, risk factors of pancreatic fistula formation were identified and analyzed. Based on our data, the incidence of pancreatic fistula in patients with a diameter of the main pancreatic duct less than 3 mm was 37.8%, with a wide one (≥3 mm) — 14.3%, p = 0.039; in patients with «hard» parenchyma — 5.8%, «soft» — 42.0%, p = 0.001. Drainage in bile ducts, the volume of intraoperative blood loss and the type of pancreaticojejunostomy did not affect on the development of pancreatic fistula.
Conclusion. Thus, the diameter of the main pancreatic duct less than 3 mm and the pancreas with «soft» parenchyma are the main factors in the development of pancreatic fistula.
Keywords: pancreatoduodenectomy, pancreatic fistula, pancreatoduodenal tumors, surgical treatment.
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