Risk factors for acute pancreatitis after minimally invasive pancreaticoduodenectomy and a prognostic analysis based on the 2022 International Study Group of Pancreatic Surgery criteria

Qian LI; Peng CAO; Cheng LIU; Bibo ZHAO; Yunpeng LIN; Guodong CHEN

doi:10.12449/JCH260618

Volume 42 Issue 6

Jun. 2026

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Article Navigation > Journal of Clinical Hepatology > 2026 > 42(6): 1358-1366

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Risk factors for acute pancreatitis after minimally invasive pancreaticoduodenectomy and a prognostic analysis based on the 2022 International Study Group of Pancreatic Surgery criteria

DOI: 10.12449/JCH260618

Qian LI¹,
Peng CAO¹,
Cheng LIU¹,
Bibo ZHAO¹,
Yunpeng LIN¹,
Guodong CHEN^{1, 2
,
,
,}

1.
Department of Hepatobiliary and Pancreatic Surgery，The First Affiliated Hospital of University of South China，Hengyang，Hunan 421001，China
2.
Department of General Surgery，Turpan People’s Hospital，Turpan，Xinjiang 838000，China

Research funding:

University of South China Clinical Research 4310 Program (20224310NHYCG01);

Central Government Guided Local Science and Technology Development Fund Project in Xinjiang Uygur Autonomous Region (ZYYD2024CG17);

Hunan Province Innovation Ecological Construction Plan Science and Technology Assistance Project in Xinjiang Uygur Autonomous Region (2024WK4008);

Interdisciplinary Research Program in Medicine and Engineering, The First Affiliated Hospital of University of South China (IRP-M&E-2025-08)

More Information

Corresponding author: CHEN Guodong， chenguodong@usc.edu.cn （ORCID： 0009-0003-5196-2007）
Received Date: 2025-12-21
Accepted Date: 2026-02-12
Published Date: 2026-06-25

Abstract

Abstract

Objective To investigate the risk factors for postpancreatectomy acute pancreatitis （PPAP） after minimally invasive pancreaticoduodenectomy （MIPD） and their association with major complications， to improve the understanding of PPAP and postoperative pancreatic fistula （POPF）， and to reduce the incidence rates of PPAP and POPF. Methods A retrospective analysis was performed for the clinical data of 114 patients who underwent MIPD in Department of Hepatobiliary and Pancreatic Surgery， The First Affiliated Hospital of University of South China， from March 2015 to December 2023， and the definition of PPAP and its diagnostic criteria provided by the International Study Group of Pancreatic Surgery were used to determine the presence or absence of PPAP. The independent samples t-test or the Mann-Whitney U rank sum test was used for comparison of continuous data between groups， and the Kruskal-Wallis H test was used for comparison between multiple groups， and the Dunn-test was used for further comparison between two groups.； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups.， and the Bonferroni-test was used for further comparison between two groups. The multivariate logistic regression analysis was used to identify the risk factors for PPAP after MIPD. Results Of all 114 patients undergoing MIPD， 27 （23.7%） experienced PPAP. The multivariate analysis showed that main pancreatic duct diameter ≤3 mm （odds ratio ［OR］=5.083， 95% confidence interval ［CI］： 1.703 — 15.172， P=0.004）， soft pancreatic texture （OR=5.925， 95%CI： 1.986 — 17.677， P=0.001）， and C-reactive protein ≥180 mg/L on day 1 after surgery （OR=5.419， 95%CI： 1.586 — 18.513， P=0.007） were independent risk factors for the onset of PPAP after MIPD. Clinical analyses showed that the patients with PPAP tended to have significantly higher incidence rates of POPF， peritoneal infection， Clavien-Dindo grade 3/4 complications， discharge with tube， and 90-day postoperative death （χ² =5.676， 5.460， 9.863， 5.439， and 4.207， all P<0.05）. Conclusion Main pancreatic duct diameter， pancreatic texture， and C-reactive protein on day 1 after surgery are closely associated with the onset of PPAP after MIPD， and PPAP can lead to other postoperative complications and even death.
- Pancreaticoduodenectomy,
- Pancreatitis,
- Risk Factors,
- Prognosis

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References(34)

References

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Risk factors for acute pancreatitis after minimally invasive pancreaticoduodenectomy and a prognostic analysis based on the 2022 International Study Group of Pancreatic Surgery criteria

DOI: 10.12449/JCH260618

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