Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Ki Byung Song;Sarang Hong;Hwa Jung Kim;Yejong Park;Jaewoo Kwon;Woohyung Lee;Eunsung Jun;Jae Hoon Lee;Dae Wook Hwang;Song Cheol Kim;Song, Ki Byung;Hong, Sarang;Kim, Hwa Jung;Park, Yejong;Kwon, Jaewoo;Lee, Woohyung;Jun, Eunsung;Lee, Jae Hoon;Hwang, Dae Wook;Kim, Song Cheol;
journal of clinical medicine 2020 Vol. 9 pp. 2766-
229
song2020journalpredictive

Abstract

Although laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume center. We used logistic regression for the analysis. The overall (13.2%) and major (3.3%) complication rates were determined. Postoperative pancreatic fistula was the most frequent complication, and 58 patients (4.7%) had clinically significant (grade B) pancreatic fistulas. No 90-day mortality was recorded. Long operative time (≥200 min), large estimated blood loss (≥320 mL), LDP performed by an inexperienced surgeon (<50 cases), and concomitant splenectomy were identified as risk factors for overall complications using a logistic regression model. For major complications, male sex (p = 0.020), long operative time (p = 0.005), and LDP performed by an inexperienced surgeon (p = 0.026) were significant predictive factors. Using logistic regression analysis, surgery-related factors, including long operative time and LDP performed by an inexperienced surgeon, were correlated with overall and major complications of LDP. As LDP is a technically challenging procedure, surgery-related variables emerged as the main risk factors for postoperative complications. Appropriate patient selection and sufficient surgeon experience may be essential to reduce the complications of LDP.

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