肝切除后胆管炎的风险因素和结果
Christopher W Mangieri1, Matthew A Strode2, Omeed Moaven3
1Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA. christopher.w.mangieri.mil@health.mil.
Langenbeck's archives of surgery
|June 17, 2023
概括
在切除肝脏后的术后胆道炎很少发生,但严重. 胆管缩和手术前支架显著增加了这种并发症的风险,导致严重的结果.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 有限的文献存在于肝切除后手术后胆管炎的发病率,风险因素和结果.
- 了解这些因素对于改善患者安全和手术结果至关重要.
研究的目的:
- 确定肝切除后手术后胆管炎的发生率和风险因素.
- 在这个患者群体中分析与手术后结肠炎相关的结果.
主要方法:
- 美国外科医生学院国家外科质量改进计划 (ACS NSQIP) 登记册的回顾性审查.
- 对2012-2016年数据的分析,包括主要和向性肝切除术手术.
- 多变量分析以确定重大风险因素和结果.
主要成果:
- 手术后结肠炎的发生率为0.64% (11,243例中151例).
- 显著的危险因素包括胆道缩 (OR 32.39) 和手术前胆道支架 (OR 18.32).
- 胆管炎与增加胆汁泄漏,肝/功能衰竭,感染,败血症,再手术,更长的住院时间,再入院和死亡率有关.
结论:
- 这是迄今为止对肝切除后手术后胆管炎的最大分析.
- 虽然罕见,但胆管炎显著增加了严重发病和死亡的风险.
- 胆道缩和支架是确定最关键的危险因素.
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