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老年患者的腹腔镜和开放性胰腺管切除术后的短期和长期结果:一种倾向性得分匹配的研究

Shuai Xu¹, Xin Deng¹, Shulin Wang²

¹Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, Shandong, 250021, China.

|May 27, 2024

概括

腹腔镜胰腺二管切除术 (LPD) 对老年患者来说是安全和可行的,与开放式手术相比,其血液损失较少,住院时间较短. 在胰腺癌患者的两种手术中,长期生存结果仍然相似.

科学领域:

手术瘤学手术瘤学
老年人手术是一门老年手术.
最少侵入性的手术

背景情况:

在老年患者 (≥65岁) 中,腹腔镜胰腺二切除术 (LPD) 的安全性和有效性仍在争论中.
这项研究比较了LPD与开放性胰腺二管切除术 (OPD) 的临床结果.

研究的目的:

评估与老年患者的OPD相比,LPD的可行性和安全性.
为了确定老年人胰腺切除术后90天死亡率的预后因素.

主要方法:

对接受LPD或OPD的老年患者 (2015-2022) 的临床数据的回顾性分析.
倾向得分匹配 (1:1) 控制混变量.
后勤回归分析以确定90天死亡率的独立预后因素.

主要成果:

在倾向分数匹配后,LPD显示估计血液损失 (EBL) 显著减少,手术内输血率降低,术后停留时间 (LOS) 缩短.
淋巴结收获在LPD组中更高.
在严重并发症,重新手术,再入院或90天死亡率方面,在LPD和OPD之间没有发现显著差异.
胰腺切除术后出血 (PPH) 被确定为90天死亡率的独立风险因素.
在接受LPD或OPD的老年胰腺管腺癌 (PDAC) 患者中,整体存活率 (OS) 类似.

结论:

腹腔镜胰腺二切除术是老年患者的安全和可行的选择,与减少EBL和更短的LOS有关.
在老年PDAC患者的LPD和OPD之间,长期生存结果没有显著差异.

关键词:

老年患者的患者.laparoscopic 胰腺切除术胰腺切除术开放性胰腺切除术胰腺管道腺癌瘤倾向性得分匹配的匹配方法

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