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Year : 2022  |  Volume : 28  |  Issue : 1  |  Page : 62-66

Factors associated with development of post-operative pancreatic fistula: A record-based observational study

1 Department of General Surgery, Aster Malabar Institute of Medical Sciences, Kozhikode, Kerala, India
2 Department of GI Surgery and Liver Transplantation, Aster Malabar Institute of Medical Sciences, Kozhikode, Kerala, India

Correspondence Address:
Dr. Amal George
Department of General Surgery, Aster Malabar Institute of Medical Sciences, Govindapuram P. O, Kozhikode - 673 016, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_3_22

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Introduction: Post-operative pancreatic fistula (POPF) is one of the major complications of pancreaticoduodenectomy (PD), which is the procedure of choice for many peripancreatic diseases. POPF may lead to or be combined with post-pancreatectomy haemorrhage and delayed gastric emptying or abscesses and sepsis, possibly leading to subsequent shock, multiorgan failure and mortality. The study was conducted with the objective to identify the factors associated with the development of POPF following PD. Methodology: This was a record-based cross-sectional study done in Kerala which recorded the details of 125 patients who underwent surgery between January 2018 and January 2020. Inclusion criteria were patients admitted with pathology in and around the head of the pancreas and requiring PD. Patient characteristics, disease-related details, pre-operative morbidities, details of surgery, and post-operative details were accessed from the patient record. Results: The mean standard deviation age of the participants was 60 (11.2) years. There was a higher proportion of males compared to females. The underlying lesion was malignant for the majority. Nearly 90% of the participants underwent classical PD. Nearly half of the patients developed POPF of which one-third were clinically relevant. Lack of history of chronic pancreatitis and post-operative drain fluid amylase was found to be significantly associated with POPF occurrence. Conclusion: Lack of history of chronic pancreatitis, amount of drainage fluid and amylase level was found to be significantly associated with the presence of post-operative fistula.

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