Comparative Analysis of Postoperative Pancreatic Fistula Following Laparoscopic and Open Gastrectomy: A Prospective Study.

This study aimed to compare the incidence of postoperative pancreatic fistula (POPF) after laparoscopic gastrectomy (LG) and open gastrectomy (OG) and to explore drainage amylase (DAMY)-related factors on patient recovery. Between April and December 2022, patients who underwent gastrectomy and met the inclusion and exclusion criteria were enrolled in this prospective study. All statistical analyses were conducted with P values at the two-sided 5% significance level and performed using the SPSS version 26. Results showed that LG and OG have no favor in POPF incidence(P > 0.05). In postoperative days 3, only two patients (6.06%) in the LG group and nine patients (13.04%) in the OG had DAMY levels three times over the upper limit of normal serum amylase range and were defined as POPF grade A. ROC curve showed that serum amylase level ≥ 140 increased the incidence of high DAMY(P = 0.026). NLR more than 8.30 was a threshold value for high DAMY level and POPF (P = 0.002). Linear regression showed that high DAMY was related to delayed postoperative recoveries(P < 0.01), prolonged postoperative hospital stays (P < 0.05), and increased readmission rates(P = 0.001). It is uncommon to have POPF grade B or C after gastrectomy without pancreatic resection. The high DAMY level has an impact on the typical postoperative recovery, and patients might have more possibility of readmission within 30 days.