胰十二指肠切除术后胰瘘的多因素分析

潘凡; 江艺; 张小进; 潘晨

胰十二指肠切除术后胰瘘的多因素分析

1. 南京军区福州总医院肝胆外科
2. 福州市传染病医院

详细信息

中图分类号: R656
计量
- 文章访问数: 3222
- HTML全文浏览量: 34
- PDF下载量: 709
- 被引次数: 0
出版历程
- 出版日期: 2012-08-20

Risk factors of pancreatic fistula after pancreaticoduodenectomy

摘要

摘要: 目的探讨胰十二指肠切除术术后胰瘘发生的高危因素。方法回顾性分析4年间在南京军区福州总院肝胆外科行胰十二指肠切除术的87例患者的临床资料,分析可能与胰瘘有关的8个因素,进行单因素及逐步Logistic多因素分析。结果术后并发症发生率为35.6%(31/87),其中胰瘘10例,发生率为11.5%,占总并发症的32.3%。多因素Logistic回归分析表明术前总胆红素水平(TBil≥171μmol/L)、胰腺质地软为胰瘘发生的独立危险因素。结论术前TBil水平(TBil≥171μmol/L)和胰腺质地软预示着较高的胰瘘发生率。
- 胰十二指肠切除术 /
- 胰腺瘘 /
- 危险因素
Abstract: Objective To investigate the risk factors of developing pancreatic fistula after pancreaticoduodenectomy. Methods Eighty-five patients who underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of Fuzhou General Hospital between January 2008 and February 2012 were studied.The management strategy and outcome, including pancreatic fistula, were evaluated.Eight potential risk factors for formation of pancreatic fistula were analyzed with univariate and multivariate logistic regression models. Results Pancreatic fistula occurred in ten of the patients, and accounted for 32.3% of the overall morbidity.Multivariate logistic regression analysis revealed that a preoperative total bilirubin (TBil) level of ≥171 μmol/L and soft texture of the pancreas were independent risk factors for pancreatic fistula. Conclusion Preoperative TBil≥171 μmol/L and soft texture of the pancreas predict a high probability of pancreatic fistula formation after pancreaticoduodenectomy.
- pancreaticoduodenectomy /
- pancreatic fistula /
- risk factors

HTML全文

参考文献(9)

[1]Suzuki Y, FujinoY, Tanioka Y, et al.Selection of pancreati-cojejunostomy techniques according to pancreatic texture andduct size[J].Arch Surg, 2002, 137 (9) :1044-1047.

[2]Shrikhande SV, Qureshi SS, Rajneesh N, et al.Pancreatic anasto-moses after pancreatic-oduodenectomy:do we need furtherstudies?[J].World J Surg, 2005, 29 (12) :1642-1649.

[3]Reid-Lombardo KM, Farnell MB, Crippa S, et al.Pancreat-ic anastomotic leakage after pancre aIicoduodenectomy in1507 patients:a report from the Pancreatic AnastomoticLeak Study Group[J].J Gastrointest Surg, 2007, 11 (11) :1451-1459.

[4]Topal B, Aerts R, Hendrickx T, et al.Determinants of com-plications in pancreaticoduodenectomy[J].Eur J Surg On-col, 2007, 33 (4) :488-492.

[5]Chen HM, Jan YY, Chao TC, et al.Panereatoduodenectomyfor chronic pancreatitis with an inflammatory mass of pancre-atic head:preoperative and postoperative functional assess-ment[J].Hepatogastmenterology, 2003, 50 (54) :2213.

[6]姜洪池, 潭洪涛, 赵玉沛.胰腺病学[M].北京:人民卫生出版社, 2007:215-219.

[7]Hosotani R, Doi R, Imamura M.Duct-to-mucosa pancreatico-jejunostomy reduces the risk of pancreatic leakage after pancreati-coduodenectomy[J].World J Surg, 2002, 26 (1) :99-104.

[8]Fujino Y, Suzuki Y, Ajiki T, et al.Risk factors influencing pan-creatic leakage and the mortality after pancreaticoduodenectomyin a medium-volume hospital[J].Hepatogastroenterology, 2002, 49 (46) :1124-1129.

[9]Yeo CJ, Cameron JL, Lillemoe KD, et al.Does prophylacticoctreotide decrease the rates of pancreatic fistula and othercomplications after pancreaticoduodenectomy?Results of aprospective randomized placebo-controlled trial[J].AnnSurg, 2000, 232 (3) :419-429.

施引文献

资源附件(0)

访问统计