Analysis of risk factors for prognosis of postoperative hemorrhage after pancreaticoduodenectomy:a report of 60 cases

doi:10.19538/j.cjps.issn1005-2208.2017.07.22

Abstract：Objective To analyze common risk factors and treatment strategy for prognosis of postoperative hemorrhage after pancreaticoduodenectomy. Methods The clinical data of 60 patients who underwent pancreaticoduodenectomy in the First Affiliated Hospital of Nanjing Medical University from January 1,2012 to December 31,2015 were analyzed retrospectively. The risk factors for prognosis of postoperative hemorrhage were analyzed. Results Among them, 8 patients died after surgery,others were alive. Early bleeding appeared in 10 patients and delayed hemorrhage occurred in 50 patients. Bleeding site included 23 gastrointestinal hemorrhage patients and 37 abdominal hemorrhage patients. Mild bleeding occurred in 37 patients and severe bleeding in 23 patients. Among them, 3 patients were grade A,40 patients grade B,17 patients grade C. Postoperative complications included postoperative pancreatic fistula in 28 patients, intra-abdominal infection in 5 patients and biliary fistula in 3 patients. Treatment strategies contained 41 patients with bleeding were treated conservatively, 9 patients received endoscopy or angioembolization while 10 patients underwent reoperation. Intra-abdominal infection and bleeding degree were important risk factors of clinical outcomes of hemorrhage after pancreaticoduodenectomy. ROC curve analysis showed that the 5th day of after surgery was a clear demarcation point of clinical prognosis. Conclusion Intra-abdominal infection, bleeding degree and grade are important risk factors of hemorrhage after pancreaticoduodenectomy. The 5th day after surgery may be a clear demarcation point of clinical prognosis, which has certain significance for the bleeding grade.