To investigate the factors influencing the stenosis of bile-intestinal anastomosis after pancreaticoduodenectomy.

The clinical data of patients who underwent PD at the Department of Hepatobiliary and Pancreatic Surgery and Medicine of the First Medical Center of the PLA General Hospital from September 2012 to October 2022 were analyzed retrospectively, and 58.17% were male and the mean age was 59.17±11.31 years. The patients were divided into the stenosis and non-stenosis groups according to whether the PD was complicated by bile-intestinal anastomosis stenosis after surgery, the relevant clinical indexes were analyzed, and the influencing factors related to postoperative complications were analyzed by the multi-factor logistic regression model.

Univariate analysis showed that age, gender, surgical approach, preoperative total bilirubin level, and clinically relevant pancreatic fistula, and the proportion of postoperative biliary fistula were significantly associated with the occurrence of postoperative anastomotic stricture in PD between the two groups (P<0.05). In multifactorial logistic regression analysis showed postoperative biliary fistula (OR=296.41, 95%CI: 23.56->999.99, P<0.05), length of surgery (OR=1.02, 95%CI: 1.01-1.03, P<0.05), postoperative total bilirubin level (OR=1.01, 95%CI: 1.00-1.02, P< 0.05), bile duct dilatation (OR=0.59, 95%CI: 0.01-0.21, P<0.05), pancreatic duct dilatation (OR=0.02, 95%CI: 0.01-0.40, P< 0.05), and postoperative albumin level (OR=0.06, 95%CI: 0.45-0.78, P< 0.05) were associated with bi-lienteric anastomosis correlation of the stenosis of the mouth.

Postoperative biliary fistula, duration of surgery, and postoperative bilirubin levels are risk factors for postoperative anastomotic stricture in PD, and bile duct dilatation, pancreatic duct dilatation, and postoperative albumin levels are protective factors.