在远端胰腺切除和脊髓切除术后收集周胰腺液 - - 什么时候需要进行干预?
Richard West1, Luke Meredith1, Elwin Tham2
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
概括
在远端胰腺切除和脊髓切除术后,手术后的周围胰腺液收集是常见的. 无症状的收集通常会自发地消失,而症状的收集可以从排水中获益,以更快地解决问题.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 腹部成像 腹部成像 腹部成像
背景情况:
- 在距离胰腺切除和脊髓切除术后,周胰腺液的收集很常见.
- 术后成像经常可以识别这些藏品.
- 自然史和干预指示需要澄清.
研究的目的:
- 为了确定远端胰腺切除和脊髓切除后围胰腺液收集的发生率.
- 描述这些收藏的自然历史.
- 为了确定干预的迹象.
主要方法:
- 对182名患者进行远端胰腺切除术,包括或不包括脊髓切除术 (2013-2018) 的回顾性审查.
- 症状性流体收集 (SFC) 和无症状流体收集 (AFC) 的比较.
- 使用千平方,曼-惠特尼U和费舍尔的精确测试进行统计分析.
主要成果:
- 46%的患者出现了周围胰腺液收集.
- 症状性流体收集 (55%) 与较高的发病率 (46%) 和胰腺 (90%) 相关.
- 对SFC (排水或抗生素) 的干预导致明显更快的解决 (3.5个月) 与观察AFC (13.2个月) 相比.
结论:
- 可以安全地观察无症状的液体收集,通常会自发消失.
- 症状性液体收集通常需要干预,最好是排水,以加速解决.
- 干预的时间和方式应以症状的发展和可行性为指导.
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