Objective:To discuss the risk factors of postoperative bleeding after pancreaticoduodenectomy (PD).
Methods:The clinical data of 305 patients receiving PD in our hospital from December 2004 to January 2008 were analyzed retrospectively.
Results:The incidence of postoperative bleeding was 9.18%.Univariate analysis showed that hypertension, preoperative blood serum bilirubin level, skeletization procedure, internal drainage, operative blood loss, intraoperative blood transfusion,post-operative hemoglobin levels and intra-abdominal infection were significantly associated with postoperative bleeding after PD. Multivariate analysis, using logistic regression, identified 4 variables as independent factors associated with the occurrence of bleeding, i.e., hypertension, preoperative blood serum bilirubin level, operative blood loss,and intra-abdominal infection. The predictive equation was P=1/{1+exp［-(-4.8785+1.2892gxy+0.0082dhs+0.0004sxl+1.5721fqgr)］}.
Conclusions:The independent risk factors for postoperative bleeding after PD are hypertension,preoperative blood serum bilirubin level more than or equal to 171 μmol/L, operative blood loss more than or equal to 700 mL, and intra-abdominal infection.Thus,appropriate perioperative management and degree of surgical skill of the operator can effectively decrease postoperative bleeding after PD.