Risk factors of biliary complications after laparoscopic pancreatic tumor enucleation
Objective:To investigate the risk factors of biliary complications after laparoscopic pancreatic tumor enucleation.Methods:The clinical and follow-up data of 101 patients who underwent laparoscopic pancreatic tumor enucleation from Mar.2017 to Jun.2023 were retrospectively analyzed.There were 29 males and 72 females,with the average age of(48.6±13.2)years(range:15 to 77 years).The tumors located in the head of the pancreas in 49 cases(48.5％)and in the neck and tail of the pancreas in 52 cases(51.5％).According to the presence or absence of biliary complications,the patients were divided into biliary complications group(n= 24)and non-biliary complications group(n=77).In univariate analysis,quantitative data were compared by t test or Mann-Whitney U test,and categorical data were compared by χ2 test.Multivariate logistic regression analysis was used to analyze the independent risk fac-tors of postoperative biliary complications.Results:All patients successfully underwent laparoscopic enucleation without intraoperative blood transfusion and conversion to open surgery.The operation time was(168.0±58.7)min(range:63 to 359 min).After long-term follow-up,biliary complications occurred in 24 patients(23.8％),including 21 cases of gallstones,2 cases of cholecystitis and 1 case of cholecystolithiasis combined with choledocholithiasis.Seventy-seven patients(76.2％)had no biliary complications.Univariate analysis showed that higher body mass index(P=0.008),higher γ-glutamyl transpeptidase level on the first postoperative day(P=0.04),tumor located in the head of the pancreas(P=0.012),longer maximum tumor diameter(P=0.028)and more somatostatin dosage(P<0.001)were risk factors for postoperative biliary complications.The above risk factors were included in multivariate logistic regression analysis,and the results showed that high body mass index(OR=1.262,95％CI=1.025～1.554,P=0.028),tumor located in the head of the pancreas(OR=4.042,95％CI=1.242～13.155,P=0.020),and large amount of somatostatin dosage(OR=1.381,95％CI =1.059～1.800,P=0.017)were independent risk factors for biliary complications after laparoscopic pancreatic tumor enuclea-tion.Conclusions:Laparoscopic enucleation of pancreatic tumor is an effective method for the treatment of benign and low malignant pancreatic tumors.For patients with the above risk factors,the occurrence of biliary complications should be monitored after discharge.
Pancreatic neoplasmsLaparoscopyEnucleation of tumorPostoperative complicationsBiliary tractRisk factors
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