| Objective To identify factors associated with postoperative pancreatic fistula(POPF) after pancreaticoduodenectomy(PD) in patients with pancreatic cancer, and to describe the relationship between POPF and quality-of-life changes during 12-month follow-up. Methods Clinical data were retrospectively collected from 180 patients with pancreatic cancer who underwent PD at the First Affiliated Hospital of Nanjing Medical University from May 2023 to February 2024. A total of 162 patients completed follow-up and were recruited in the analysis, including 76 patients with POPF and 86 patients without POPF. Demographic characteristics, preoperative laboratory results, and operative variables were extracted. Quality of life was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30) before surgery and at 3, 6, and 12 months after surgery. Univariate analysis and multivariate logistic regression were performed to determine factors related to POPF, and repeated-measures analysis of variance was used to compare the longitudinal quality-of-life scores. Results Age, BMI, diabetes history, pancreatic texture, and pancreatic duct diameter differed significantly between the two groups in univariate comparisons(P<0.05). Multivariate logistic regression showed that soft pancreatic texture and a pancreatic duct diameter <3 mm were independent risk factors for POPF after PD(P<0.05). During follow-up, the POPF group had lower functional-scale and global-health-status scores than the control group at 3, 6, and 12 months postoperatively(P<0.05). Symptom-scale scores were higher in the POPF group at 3 and 6 months(P<0.05), whereas the between-group difference was not significant at 12 months(P>0.05). Conclusion Soft pancreatic texture and a pancreatic duct diameter <3 mm are closely associated with POPF after PD. POPF may delay functional recovery and reduce perceived overall health, indicating the need for perioperative risk stratification and continued postoperative nutritional, symptomatic, and rehabilitation management. |
