Zarzavadjian Le Bian et al reported risk factors for a pancreatic fistula after pancreaticoduodenectomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in France and Italy.
Patient selection: status post pancreaticoduodenectomy
Most common reason for surgery: pancreatic ductal adenocarcinoma
Outcome: pancreatic fistula (drain output of any measurable volume >= 3 days after surgery AND drainage fluid amylase activity >= 3 times serum amylase activity)
Predictors of a pancreatic fistula:
(1) high body mass index (BMI), > 25 kg per square meter
(2) peri-operative blood transfusion
(3) increased hospital stay
The risk of in-hospital mortality was increased for a patient with a pancreatic fistula.
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