Analysis of postoperative complications and risk factors following extended pancreaticoduodenectomy

Abstract

Objective The present study aimed at investigating the complications following extended pancreaticoduodenectomy and analyzing risk factors. Methods Clinical data of patients undergoing pancreaticoduodenectomy between November 2004 and November 2014 were collected, and were divided into Standard Group and Extended Group retrospectively. The postoperative complications and risk factors were analyzed by uni-variate and multi-variate logistic analysis. Results Three hundred and fifty-eight patients were subjected to pancreaticoduodenectomy, 321 cases in Standard Group and 37 cases in Extended Group. The total morbidity was 41.1% and mortality was 5.0%. The differences of intra-abdominal complications (P = 0.02) and delayed gastric emptying (P = 0.01) were significant between the groups. Multi-variate logistic analysis revealed that age over 65 (P < 0.01), operation time more than 360 min (P = 0.03), pancreatic duct diameter less than 3 mm (P < 0.01), soft texture of remnant pancreas (P < 0.01), extended pancreaticoduodenectomy (P = 0.02) and invagination pancreaticojejunostomy (P = 0.01) were independent risk factors for intra-abdominal complications. And independent risk factors for delayed gastric emptying included extended pancreaticoduodenectomy (P = 0.03), operation time more than 360 min (P < 0.01), soft texture of remnant pancreas (P = 0.02) and pancreatic duct diameter less than 3 mm (P < 0.01). Conclusion Extended pancreaticoduodenectomy is the independent risk factor for intra-abdominal complications, while it does not increase the mortality. Key words: Extend pancreaticoduodenectomy; Intra-abdominal complications; Delayed gastric emptying; Independent risk factors