Table 4.
Subgroup analysis of risk factors for the development of postoperative complications of grades IIIa or higher, grades IIIb or higher according to the Clavien-Dino classification, and specific types of postoperative complications, including severe bile leakage, severe postoperative pancreatic fistula, delayed gastric emptying, hemorrhage, and intra-abdominal infection in patients who underwent laparoscopic pancreatoduodenectomy
| POCs | Variables |
Univariate analysis
|
Multivariate analysis
|
||
|
OR (95%CI)
|
P value
|
OR (95%CI)
|
P value
|
||
| CDc grade IIIb or higher | ECOG score, 2 vs 0-1 | 3.415 (1.659-7.028) | 0.001 | 4.169 (1.895-9.174) | < 0.001 |
| Preoperative biliary drainage, yes vs no | 0.225 (0.054-0.940) | 0.041 | 0.138 (0.032-0.600) | 0.008 | |
| Smoking, yes vs no | 1.735 (0.970-3.101) | 0.063 | 1.496 (0.727-3.079) | 0.274 | |
| Drinking, yes vs no | 1.712 (0.952-3.078) | 0.072 | 1.650 (0.791-3.440) | 0.182 | |
| ALP, ≥ 140 U/L vs < 140 U/L | 1.783 (0.896-3.546) | 0.099 | 1.614 (0.717-3.634) | 0.247 | |
| RDW, ≥ 15.4 vs < 15.4 | 2.326 (1.298-4.169) | 0.005 | 2.127 (1.116-4.055) | 0.022 | |
| Lymphocyte, ≥ 3.2 × 109/L vs < 3.2 × 109/L | 6.383 (1.206-33.775) | 0.029 | 6.536 (1.068-39.978) | 0.042 | |
| CRP, ≥ 10 mg/L vs < 10 mg/L | 1.836 (1.020-3.302) | 0.043 | 1.400 (0.741-2.646) | 0.300 | |
| Severe POPF (grade B and C) | Age, ≥ 65 years vs < 65 years | 1.756 (1.113-2.772) | 0.016 | 1.435 (0.889-2.316) | 0.139 |
| ECOG score, 2 vs 0-1 | 2.671 (1.433-4.981) | 0.002 | 2.878 (1.435-5.774) | 0.003 | |
| Operative time | 0.997 (0.994-1.000) | 0.026 | 0.996 (0.993-0.999) | 0.006 | |
| RDW, ≥ 15.4 vs < 15.4 | 2.442 (1.539-3.875) | < 0.001 | 2.246 (1.320-3.820) | 0.003 | |
| Hemoglobin, ≥ 115 g/L vs < 115 g/L | 0.544 (0.335-0.882) | 0.014 | 0.856 (0.495-1.481) | 0.579 | |
| Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L | 1.755 (0.924-3.334) | 0.086 | 1.609 (0.815-3.177) | 0.170 | |
| Albumin, < 35 g/L vs ≥ 35 g/L | 1.885 (1.130-3.143) | 0.015 | 1.153 (0.641-2.074) | 0.643 | |
| PT, ≥ 14 seconds vs < 14 seconds | 0.343 (0.106-1.115) | 0.075 | 0.229 (0.067-0.783) | 0.019 | |
| Severe BL | Diabetes mellitus, yes vs no | 3.110 (1.408-6.870) | 0.005 | 2.484 (1.105-5.583) | 0.028 |
| Smoking, yes vs no | 2.010 (1.289-3.133) | 0.002 | 1.660 (0.959-2.874) | 0.070 | |
| Drinking, yes vs no | 1.580 (1.005-2.484) | 0.048 | 1.200 (0.687-2.097) | 0.522 | |
| BMI ≥ 24 kg/m2 vs < 24 kg/m2 | 2.442 (1.439-4.143) | 0.001 | 1.988 (1.143-3.456) | 0.015 | |
| Intra-operative blood transfusion, yes vs no | 1.660 (1.050-2.625) | 0.030 | 1.210 (0.707-2.072) | 0.487 | |
| RDW, ≥ 15.4 vs < 15.4 | 3.587 (2.287-5.628) | < 0.001 | 3.401 (1.979-5.845) | < 0.001 | |
| Hemoglobin, ≥ 115 g/L vs < 115 g/L | 0.648 (0.401-1.048) | 0.077 | 0.824 (0.448-1.515) | 0.533 | |
| TBIL, ≥ 235 μmol/L vs < 235 μmol/L | 2.188 (1.402-3.417) | 0.001 | 1.326 (0.776-2.264) | 0.302 | |
| Albumin, < 35 g/L vs ≥ 35 g/L | 2.326 (1.434-3.774) | 0.001 | 1.290 (0.721-2.309) | 0.391 | |
| CRP, ≥ 10 mg/L vs < 10 mg/L | 1.527 (0.967-2.413) | 0.069 | 1.138 (0.679-1.907) | 0.623 | |
| Severe hemorrhage | ECOG score, 2 vs 0-1 | 2.715 (1.455-5.066) | 0.002 | 2.832 (1.447-5.540) | 0.002 |
| Smoking, yes vs no | 1.937 (1.223-3.068) | 0.005 | 1.437 (0.820-2.517) | 0.206 | |
| Drinking, yes vs no | 2.064 (1.299-3.278) | 0.002 | 1.858 (1.047-3.297) | 0.034 | |
| RDW, ≥ 15.4 vs < 15.4 | 1.998 (1.252-3.189) | 0.004 | 1.794 (1.050-3.063) | 0.032 | |
| GGT, ≥ 45 U/L vs < 45 U/L | 1.735 (0.969-3.108) | 0.064 | 1.215 (0.640-2.307) | 0.551 | |
| Albumin, < 35 g/L vs ≥ 35 g/L | 1.792 (1.067-3.008) | 0.027 | 1.022 (0.559-1.869) | 0.944 | |
| CRP, ≥ 10 mg/L vs < 10 mg/L | 1.582 (0.986-2.536) | 0.057 | 1.181 (0.699-1.997) | 0.534 | |
| Intra-abdominal infection | Age, ≥ 65 vs < 65 | 1.539 (1.067-2.220) | 0.021 | 1.363 (0.928-2.001) | 0.114 |
| ECOG score, 2 vs 0-1 | 1.887 (1.076-3.310) | 0.027 | 1.725 (0.957-3.109) | 0.070 | |
| Hypertension, yes vs no | 1.577 (1.069-2.326) | 0.022 | 1.365 (0.909-2.052) | 0.134 | |
| Drinking, yes vs no | 1.603 (1.100-2.338) | 0.014 | 1.556 (1.052-2.301) | 0.027 | |
| RDW, ≥ 15.4 vs < 15.4 | 1.483 (1.008-2.180) | 0.045 | 1.201 (0.793-1.817) | 0.387 | |
| Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L | 1.618 (0.942-2.779) | 0.081 | 1.247 (0.703-1.817) | 0.450 | |
| TBIL, ≥ 235 μmol/L vs < 235 μmol/L | 1.426 (0.977-2.081) | 0.066 | 1.585 (1.027-2.446) | 0.038 | |
| CRP, ≥ 10 mg/L vs < 10 mg/L | 1.675 (1.147-2.448) | 0.008 | 1.304 (0.868-1.960) | 0.202 | |
| Severe DGE | Pathology, malignant tumors vs benign tumors | 1.652 (0.944-2.892) | 0.079 | 1.058 (0.548-2.042) | 0.886 |
| Preoperative biliary drainage, yes vs no | 0.365 (0.130-1.024) | 0.055 | 0.421 (0.144-1.236) | 0.155 | |
| Pancreatitis, yes vs no | 2.748 (1.354-5.578) | 0.005 | 2.555 (1.158-5.639) | 0.020 | |
| Intra-operative blood transfusion, yes vs no | 1.931 (1.137-3.279) | 0.015 | 1.667 (0.901-3.082) | 0.103 | |
| ASA, III vs I-II | 1.683 (0.935-3.031) | 0.083 | 1.893 (1.028-3.487) | 0.041 | |
| RDW, ≥ 15.4 vs < 15.4 | 1.105 (0.629-1.940) | 0.729 | 1.130 (0.573-2.226) | 0.725 | |
| Operative time | 1.003 (1.000-1.005) | 0.028 | 1.002 (0.999-1.005) | 0.212 | |
| Lymphocyte, ≥ 3.2 × 109/L vs < 3.2 × 109/L | 4.913 (0.933-25.861) | 0.060 | 4.019 (0.696-23.193) | 0.120 | |
| ALP, ≥ 140 U/L vs < 140 U/L | 2.131 (1.265-3.588) | 0.004 | 2.913 (1.538-5.518) | 0.001 | |
| Albumin, < 35 g/L vs ≥ 35 g/L | 2.201 (1.251-3.871) | 0.006 | 3.065 (1.568-5.992) | 0.001 | |
| CCI ≥ 26.2 | Intra-operative blood transfusion, yes vs no | 1.489(1.087-2.041) | 0.013 | 1.150 (0.816-1.621) | 0.425 |
| Preoperative biliary drainage, yes vs no | 0.695 (0.456-1.060) | 0.091 | 0.573 (0.368-0.891) | 0.014 | |
| RDW, ≥ 15.4 vs < 15.4 | 1.964 (1.436-2.687) | < 0.001 | 1.680 (1.185-2.382) | 0.004 | |
| Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L | 1.854 (1.171-2.936) | 0.008 | 1.740 (1.076-2.815) | 0.024 | |
| Albumin, < 35 g/L vs ≥ 35 g/L | 1.918 (1.341-2.743) | < 0.001 | 1.511 (1.017-2.244) | 0.041 | |
| Platelet, ≥ 350 × 109/L vs 350 × 109/L | 1.472 (0.973-2.229) | 0.067 | 1.241 (0.798-1.930) | 0.337 | |
POCs: Postoperative complications; OR: Odds ratio; CI: Confidence interval; CDc: Clavien-Dino classification; ECOG: Eastern Cooperative Oncology Group; BMI: Body mass index; ASA: American Society of Anesthesiologists; RDW: Red blood cell distribution width; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyl transferase; TBIL: Total bilirubin; CRP: C-reactive protein; PT: Prothrombin time; POPF: Postoperative pancreatic fistula; BL: Bile leakage; DGE: Delayed gastric emptying; CCI: Comprehensive complication index.