Risk Factors of Massive Bleeding Related to Pancreatic Leak after Pancreaticoduodenectomy - 21/08/11
Correspondence address: Yu-Wen Tien, MD, PhD, Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Rd, Taipei 10002, Taiwan, ROCRésumé |
Background |
Most pancreatic leaks after pancreaticoduodenectomy were initially treated conservatively, and for the most part, they were self-limiting and closed spontaneously. But in a few patients, hemorrhage occurred 1 to 3weeks postoperatively and remained a fatal complication after pancreaticoduodenectomy.
Study design |
To identify possible risk factors for massive bleeding, the medical records of 402 patients who had pancreaticoduodenectomies were reviewed for leak complications and analyzed for associations between the occurrence of massive bleeding and preoperative, intraoperative, postoperative, and pathologic parameters.
Results |
In univariate logistic regression analysis, infectious clinical signs (p=0.021, odds ratio [OR]=7.06, 95% CI=1.34, 37.12) and bile in the drainage fluid (p=0.036, OR=5.89, 95% CI=1.13, 30.86) were associated with the risk of developing massive hemorrhage. This combination provided the highest estimate of massive bleeding after pancreatic leak (p=0.005, OR=8.57, 95% CI=1.92, 38.35).
Conclusions |
Both infectious clinical signs and bile content in the drainage fluid considerably increase the risk of massive bleeding after pancreatic leak. Close observation of patients with these ominous signs is warranted.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : OR, PJ, TAE
Plan
| Competing Interests Declared: None. |
Vol 201 - N° 4
P. 554-559 - octobre 2005 Retour au numéro
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