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在胰腺二切除术后的腹腔内预防性排水:一项意大利调查

Claudio Ricci^1,2, Nicolò Pecorelli^3,4,5, Alessandro Esposito^6,5

¹Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy. claudio.ricci6@unibo.it.

Updates in surgery

|April 25, 2024

概括

外科医生对在胰腺突切除术 (PD) 期间使用腹腔内预防性排水 (IPD) 有不同的看法. 虽然大多数人使用IPD,但在不使用它们时会感到很遗憾,这表明IPD对于管理PD并发症有价值.

科学领域:

胃肠病学和肝病学胃肠学和肝病学
手术瘤学手术瘤学
临床外科临床外科

背景情况:

在胰腺突切除术 (PD) 中使用腹腔内预防性排水 (IPD) 仍然是外科医生争论的主题.
目前的做法和关于IPD使用的外科医生决策尚未完全理解.

研究的目的:

调查当前的外科医生实践和对IPD在PD使用的态度.
在临床场景中量化与IPD遗漏或犯下的外科医生遗憾.
确定影响外科医生对IPD使用决策的因素,并确定排水缺失的风险值.

主要方法:

一项调查分发给外科医生,包括23个问题和一个临床图片,评估对IPD遗漏和错误的遗憾0-100级.
统计分析使用值模型和多层混合回归来评估外科医生的反应.
从103名外科医生收集了数据,97.2%的外科医生报告使用至少两种IPD.

主要成果:

遗憾不使用IPD的中位数很高 (84),而对使用IPD的遗憾很低 (10).
术后胰腺 (CR-POPF) 的临界概率值,在该值下,省略IPD是不那么令人遗憾的,为3%.
诸如微侵袭性PD,晚期排水,FRS感知风险预测和IPDs预防复原切除术等因素与较低的遗憾值相关.

结论:

在PD后的外科医生排水管理政策是异质的.
遗憾模型表明,IPD遗漏可能是被认为并发症风险低的患者的安全策略.
需要进一步的研究来标准化排水管理协议,并优化PD后患者的治疗结果.

关键词:

排水系统排水系统进行胰腺切除术.问卷问卷问卷问卷后悔表示遗憾调查调查调查调查

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