Arguments for an individualized closure of the pancreatic remnant after distal pancreatic resection

Table 1 Patients and operations, univariate and multivariate analysis of risk factors for the occurrence of postoperative pancreatic fistula B/C, median (range) n (%)

Parameter		No POPF (n = 96)	POPF (n = 30)	Odds ratio	P uni-variate	P multi-variate
Patients
Age (yr)	61 (24-83)	61 (24-82)	61 (24-83)	1.002	0.859
Sex (M:F)	49:77	38:58	11:19	0.884	0.775
BMI (kg/m2)	24 (16-41)	24 (16-34)	27 (17-41)	1.181	0.001	0.009
Diabetes	24 (19.0)	20	4	0.585	0.365
Alcohol	23 (18.3)	19	4	0.623	0.427
Crea (mg/dL)	0.80 (0.40-1.87)	0.80 (0.40-1.87)	0.80 (0.46-1.40)	0.806	0.827
WBC (tsd/μL)	6.9 (2.6-18.5)	6.9 (2.6-18.5)	6.8 (3.2-17.7)	0.978	0.759
Hb (g/dL)	13.2 (7.8-16.8)	13.1 (7.8-16.8)	13.4 (10.7-16.6)	1.189	0.174
Bili (mg/dL)	0.6 (0.2-1.8)	0.6 (0.2-1.4)	0.6 (0.2-1.8)	0.635	0.545
Operations
Period 94-01	43 (34)	37	6	2.508	0.067
Period 02-09	83 (66)	59	24
OP time	270 (125-570)	270 (125-570)	269 (157-510)	0.996	0.154
DC-HS	47 (37.3)	30	17	2.877	0.014	0.030
DC-S	18 (14.3)	16	2	0.357	0.188
PJ	52 (41.3)	43	9	0.528	0.154
SMP	9 (7.1)	7	2	0.908	0.908
Splenectomy	109 (86.5)	84	25	0.714	0.561
Multivisceral	26 (20.6)	23	3	0.353	0.111
Histopathology
PDAC	38 (28.6)	32	4	0.308	0.042
CP	40 (31.7)	32	8	0.727	0.495
CNP	21 (16.7)	12	9	3.000	0.029
NET	16 (12.7)	12	4	1.077	0.905
OTH	13 (10.3)	8	5	2.200	0.199
High-risk	50 (39.5)	32	18	3.000	0.011	0.168

Univariate and multivariate analysis: binary logistic regression. POPF: Postoperative pancreatic fistula (International Study Group for Pancreatic Surgery definition); CI: Confidence interval; BMI: Body mass index; DC-HS: Direct closure hand suture; DC-S: Direct closure stapler; PJ: Pancreatojejunostomy; SMP: Seromuscular patch; PDAC: Pancreatic ductal adenocarcinoma; CP: Chronic pancreatitis; CNP: Cystic neoplasia of the pancreas; NET: Neuroendocrine tumor; OTH: Other pancreatic pathology. CNPs were: 2 intraductal papillary mucinous neoplasia, 2 solid pseudopapillary neoplasia, 11 serous cystic adenoma, 6 mucinous cystic neoplasia. High-risk pancreas is defined as pathology with odds ratio > 1 i.e., other than PDAC or CP, periods of time are 1994-2001 vs 2002-2009.