Objective To investigate the influencing factors of prolonged postoperative ileus(PPOI)in patients undergoing pancreaticoduodenectomy(PD)during hospitalization.Methods The data of 339 patients underwent PD admitted to the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2018 to September 2023 were retrospectively analyzed,including 204 males and 135 females,aged(60.6±11.2)years.Among the 339 patients,112(33.0％)had pancreatic tumors,94(27.7％)had Vater ampullary tumors,82(24.2％)had common bile duct tumors,and 51(15.0％)had duodenal tumors.A total of 339 patients with PPOI were included in the PPOI group(n=43)and those without PPOI were included in the control group(n=296).The two groups were compared in terms of age,PD operation(open or laparoscopic),gastrojejunostomy(retrocolic or antecolic gastrojejunos-tomy),grade B or C pancreatic fistula,hypokalemia,and postoperative use of patient-controlled intravenous analgesia(PCIA).The index comparing P＜0.05 between the two groups was further included in the multi-variate logistic regression analysis to analyze the influencing factors of PPOI in PD patients.Results There were statistically significant differences in age＞70 years,PD operation,gastrojejunostomy,grade B or C pancreatic fistula,hypokalemia,and postoperative use of PCIA between the two groups(all P＜0.05).Multivariate logistic regression analysis showed grade B or C pancreatic fistula(OR=3.17,95％CI:1.48-6.82),open surgery(OR=2.90,95％CI:1.35-6.24),retrocolic gastrojejunostomy(OR=2.47,95％CI:1.23-4.95),postoperative usage of PCIA(OR=2.61,95％CI:1.21-5.62),age＞70 years(OR=2.47,95％CI:1.71-5.19)had a high risk of PPOI during postoperative hospitalization(all P＜0.05).Conclusion Postoperative grade B or C pancreatic fistula,open surgery,retrocolic gastrojejunostomy(com-pares with antecolic gastrojejunostomy),postoperative using PCIA,and age＞70 years are independent risk factors for PPOI in patients undergoing PD during postoperative hospitalization.
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