Risk factors of postoperative pancreatic fistula after distal pancreatectomy using a triple-row stapler

Postoperative pancreatic fistula (POPF) is one of the major complications in patients who undergo distal pancreatectomy (DP). Recently, dividing the pancreas by stapler is a commonly performed technique, however, POPF still occurs. Therefore, the purpose of this study was to investigate the risk factors for POPF after DP using a triple-row stapler. A total of 75 patients underwent DP using a triple-row stapler (Endo GIA (TM) Reloads with Tri-Staple (TM) Technology 60 mm; COVIDIEN, North Haven, CT, USA) at Yamanashi University from December 2012 to December 2016. The clinical risk factors for POPF after DP using a triple-row stapler were identified based on univariate and multivariate analyses. Clinical POPF (ISGPF Grade B and C) was seen in 7 of 75 patients (9.3%). The body mass index (BMI) was significantly higher in the patients with POPF (26.8 +/- 0.5 kg/m(2)) compared with the patients without POPF (21.4 +/- 0.4 kg/m(2); a cut-off value; 25.7 kg/m(2)). In addition, the patients with POPF were significantly younger than the patients without POPF (56.4 +/- 5.6 vs 67.0 +/- 1.5; a cut-off value was 57.0 years old). BMI and age were found to be significant risk factors for POPF after DP using a triple-row stapler.