Abstract: Objective To analyze the relevant factors of pancreatic fistula post operation of pancreaticoduodenectomy with external drainage of pancreatic duct. Methods A total of 133 patients undergoing pancreaticoduodenectomy with external drainage of pancreatic duct in our hospital from 1999 to 2011 were retrospectively analyzed. Logistic regression analysis was used to analyze the relevance of pancreatic fistula with age, gender, combined diseases, pancreatic duct diameter, pathological types, preoperative total bilirubin(TBIL) and albumin(ALB) levels, drainage of the bile duct before operation, obstruction of the pancreatic duct drainage and postoperative application of growth somatostatin.Then we also analyzed the relationship between the risk factors and the severity of pancreatic fistula. Results Postoperative pancreatic fistula occurred in 24 cases (3 cases of grade A,13 cases of grade B and 8 cases of grade C)among the 133 patients. Logistic regression analysis showed that obstruction of the pancreatic duct drainage is a major risk factor of pancreatic fistula in these patients（OR=4.529，P=0.005）. The patients whose pancreatic duct drainage was obstructed had a significantly higher pancreatic fistula rate than the patients whose drainage was not obstructed (30.8% vs. 12.8%, P<0.05). The occurrence of pancreatic fistula has no significant correlation with age, gender, combined diseases, pancreatic duct diameter, pathological types, preoperative TBIL, ALB level, preoperative bile duct drainage and postoperative application of somatostatin. And in those pancreatic fistula patients, the pancreatic fistula was severity in the obstructed ones than the unobstructed ones.Conclusion The obstruction of the pancreatic duct drainage is a major risk factor of pancreatic fistula after pancreaticoduodenectomy with external drainage of pancreatic duct. If adequate preventive measures were done in operation process to decrease the opportunity of pancreatic duct drainage obstruction, the incidence of pancreatic fistula and pancreatic fistula severity will be significantly reduced.

Key words: 　pancreatic fistula, pancreaticoduodenectomy, pancreatic duct, drainage