Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients

Abstract

The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785–25.792; P=0.005), history of abdominal surgery (OR = 5.009; 95% CI: 1.968–12.749; P=0.001), and preoperative albumin levels (OR = 4.863; 95% CI: 1.962–12.005; P=0.001). Independent risk factors of late PPH included postoperative pancreatic leakage (OR = 4.696; 95% CI: 1.605–13.740; P=0.005), postoperative biliary fistula (OR = 6.096; 95% CI: 1.575–23.598; P=0.009), postoperative abdominal infection (OR = 4.605; 95% CI: 1.108–19.144; P=0.036), revascularization (OR = 9.943; 95% CI: 1.900–52.042; P=0.007), history of abdominal surgery (OR = 8.790; 95% CI: 2.779–27.806; P<0.001), and preoperative albumin levels (OR = 5.563; 95% CI: 1.845–16.776; P=0.002).