{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:36:52Z","timestamp":1790725012783,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,11,29]],"date-time":"2009-11-29T00:00:00Z","timestamp":1259452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The mortality associated with distal pancreatectomy (DP) has declined to &lt;5% in recent years in high\u2010volume centers. However, morbidity remains high, ranging from 32% to 57%. Pancreatic fistula (PF) is the most common complication after DP. The aim of this study was to analyze factors associated with the occurrence of clinical PF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed of the medical records of 100 patients who underwent DP in our institution between May 2001 and January 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no mortality, but morbidity was occurred in 65 patients (65%), with major complications occurring in 9 patients (9%). PF occurred in 50 patients (50%) and clinical PF occurred in 23 patients (23%). Multivariate analysis indicated that independent risk factors for clinical PF were: age younger than 65 years (<jats:italic>P<\/jats:italic> = 0.049; odds ratio (OR) 2.958; 95% confidence interval (CI) 1.007\u20138.688), not ligating the main pancreatic duct (MPD) (<jats:italic>P<\/jats:italic> = 0.02; OR 4.933; 95% CI 1.283\u201318.967), and extended lymphadenectomy (<jats:italic>P<\/jats:italic> = 0.008; OR 4.773; 95% CI 1.504\u201315.145).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Age &lt; 65 years, not ligating the MPD, and extended lymphadenectomy are independent risk factors for clinical PF.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-009-0300-3","type":"journal-article","created":{"date-parts":[[2009,11,28]],"date-time":"2009-11-28T16:50:46Z","timestamp":1259427046000},"page":"121-125","source":"Crossref","is-referenced-by-count":84,"title":["Risk Factors for Clinical Pancreatic Fistula After Distal Pancreatectomy: Analysis of Consecutive 100\u00a0Patients"],"prefix":"10.1002","volume":"34","author":[{"given":"Ryuji","family":"Yoshioka","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Saiura","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Seki","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Kishi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Morimura","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research 3\u201010\u20106 Ariake 135\u20108500 Koto\u2010ku Tokyo 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