Analysis of risk factors for postoperative pancreatic fistula following pancreaticoduodenectomy

Table 1 Main parameters for postoperative pancreatic fistula grading

Grade	A	B	C
Clinical conditions	Well	Often well	III appearing/bad
Specific treatment1	No	Yes/no	Yes
US/CT, if obtained	Negative	Negative/positive	Positive
Persistent drainage, after 3 wk2	No	Usually yes	Yes
Reoperation	No	No	Yes
Death related to POPF	No	No	Possibly yes
Signs of infections	No	Yes	Yes
Sepsis	No	No	Yes
Readmission	No	Yes/no	Yes/no

¹Partial (peripheral) or total parenteral nutrition, antibiotics, enteral nutrition, somatostatin analogue, and/or minimally invasive drainage;

²With or without a drain in situ. CT: Computed tomography scan; POPF: Postoperative pancreatic fistula; US: Ultrasonography.

Table 2 Univariate analysis of predictors for pancreatic fistula following pancreaticoduodenectomy

Characteristic	POPF occurrence				CR-POPF occurrence
	Yes	No	P value	χ2	Yes	No	P value	χ2
Sex			0.429	0.625			0.715	0.134
Male	81	41			41	81
Female	45	29			23	51
Age in years			0.492	0.471			0.119	2.433
≥ 60	53	33			23	63
< 60	73	37			41	69
BMI in kg/m2			0.696	0.153			0.052	3.791
≥ 25	38	23			14	47
< 25	88	47			50	85
Hypertension			0.728	0.121			0.930	0.008
Yes	39	20			19	40
No	87	50			45	92
Diabetes mellitus			0.431	0.621			0.959	0.003
Yes	18	13			10	21
No	108	57			54	111
Serum CA19-9 in mg/L			0.257	1.285			0.774	0.082
> 37	65	42			34	73
≤ 37	61	28			30	59
Pre-operative jaundice			0.638	0.222			0.147	2.102
Yes	71	37			40	68
No	55	33			24	64
Serum albumin in g/L			0.572	0.319			0.498	0.460
< 35	18	8			10	16
≥ 35	108	62			54	116
Blood loss in mL			0.109	2.576			0.639	0.220
≥ 600	16	15			9	22
< 600	110	55			55	110
Pancreatic duct diameter in mm			0.000	15.696			0.008	6.952
≤ 3	75	21			40	56
> 3	51	49			24	76
Pylorus-preserving			0.798	0.066			0.159	1.987
Yes	57	33			34	56
No	69	37			30	76
Pancreatic drainage			0.800	0.064			0.023	5.180
External	40	21			13	48
Enteral	86	49			51	84
Pancreatico-jejunostomy			0.307	1.043			0.766	0.089
Duct-to-mucosa	117	62			59	120
Invagination	9	8			5	12

CR-POPF: Clinically relevant postoperative pancreatic fistula; POPF: Postoperative pancreatic fistula.

Table 3 Logistic regression for predictors of pancreatic fistula following pancreaticoduodenectomy

Variable	B	SE	Wals	P value	OR	95%CI
Total PF
Pancreatic duct diameter	-1.233	0.318	15.056	0.000	0.291	0.156-0.543
Clinically relevant PF
Pancreatic duct diameter	-0.919	0.321	8.171	0.004	0.399	0.213-0.749
Pancreatic drainage	-0.932	0.370	6.339	0.012	0.394	0.191-0.813

B: Regression coefficient; PF: Pancreatic fistula; Wals: χ² value.