Risk factors for surgical complications in distal pancreatectomy

Seeliger, Hendrik; Christians, Simone; Angele, Martin K.; Kleespies, Axel; Eichhorn, Martin E.; Ischenko, Ivan; Boeck, Stefan; Heinemann, Volker; Jauch, Karl-Walter; Bruns, Christiane J.

doi:10.1016/j.amjsurg.2009.10.022

« Previous Next »The American Journal of Surgery
Volume 200, Issue 3 , Pages 311-317, September 2010

Risk factors for surgical complications in distal pancreatectomy

Hendrik Seeliger, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
- Corresponding author. Tel.: +49 89 7095 0; fax: +49 89 7095 8894
Simone Christians, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Martin K. Angele, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Axel Kleespies, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Martin E. Eichhorn, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Ivan Ischenko, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Stefan Boeck, M.D.
- Department of Internal Medicine III, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Volker Heinemann, M.D.
- Department of Internal Medicine III, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Karl-Walter Jauch, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany
Christiane J. Bruns, M.D.
- Department of Surgery, Grosshadern Campus, Munich University Medical Center, Munich, Germany

Received 30 May 2009; received in revised form 21 October 2009 published online 12 April 2010.

Abstract

Background

Pancreatic fistula (PF) represents a major complication after distal pancreatectomy. In a consecutive series of 110 patients, risk factors for the incidence of PF and surgical morbidity were identified.

Methods

Patients having undergone distal pancreatectomy between 2003 and 2007 were identified. Clinicopathologic parameters as well as perioperative data were correlated with the incidence of PF and overall surgical morbidity using univariate and multivariate models.

Results

In 72 patients (65%), malignant disease was present. Splenectomy and multivisceral resection were performed in 84 (76%) and 47 (42%) patients, respectively. Overall major surgical morbidity was 18%, and 12 patients (11%) developed PFs. A body mass index > 25 kg/m² was the only independent significant predictive factor for PF. Malignancy, splenectomy, multivisceral resection, transfusion, comorbidity, and stapler use did not show statistical significance. For overall surgical morbidity, there was no significant indicator.

Conclusions

A body mass index > 25 kg/m² contributes to the incidence of PF after distal pancreatectomy. Other parameters did not show a significant influence on PF or on overall surgical morbidity.

Keywords: Distal pancreatectomy, Pancreatic fistula, Complications, Body mass index