Supplementary Material for: Predictors of Postoperative Non-Chylous Massive Discharge after Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma

Background: Pancreaticoduodenectomy (PD) is performed
for pancreatic ductal adenocarcinoma (PDA) located at the pancreas
head/body. Non-chylous massive discharge after PD is frequently
encountered and can cause a vicious cycle of complications associated
with severe dehydration and protein loss. Methods: From
August 2008 to June 2015, 102 patients who underwent PD for PDA were
retrospectively reviewed. High non-chylous discharge was defined as
postoperative daily serous discharge exceeding 10 mL/kg. Predictive
factors for high non-chylous discharge were assessed using multivariable
analysis. Results: Fifty-one patients (50%) developed
high non-chylous discharge. Body mass index (BMI) and hemoglobin, total
protein, and cholinesterase levels were significantly lower in the
high-discharge group compared to the corresponding levels in the
low-discharge group. The incidence of postoperative pancreatic fistula
and delayed gastric emptying was significantly lower and higher in the
high-discharge group than in the low-discharge group, respectively.
Multivariable analysis revealed that BMI <22.0 kg/m2,
hemoglobin <12.0 g/dL and intraoperative blood loss ≥800 mL were
independent predictive factors for high non-chylous discharge. Conclusions:
Preoperative low levels of BMI and hemoglobin and intraoperative high
blood loss were independent predictive factors for high non-chylous
discharge. Improvement of preoperative general and nutritional condition
may reduce the incidence of high non-chylous discharge.