按需排水和灌可以减少严重的败血症并发症和胰腺切除中的死亡率
Alexander Gluth1, Hubert Preissinger-Heinzel1, Katharina Schmitz1
1Department of Surgery, Evangelisches Krankenhaus Düsseldorf, Kirchfeldstr. 40, 40217, Düsseldorf, Germany.
Langenbeck's archives of surgery
|September 11, 2024
概括
在胰腺切除中,常规排水与按需灌是安全的. 这种方法显著降低了关联的并发症和重新干预率,改善了胰腺二切除术和远部胰腺切除术后的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 腹部外科手术 腹部外科手术
背景情况:
- 胰腺切除后常规排水放置的必要性仍在争论中.
- 一些研究表明,省略排水是安全的,而另一些研究报告了高的重新干预和死亡率.
研究的目的:
- 为了评估患者经历胰腺切除与常规排水放置和按需排水灌的患者的带相关的结果.
- 评估标准化排水方案的安全性和有效性.
主要方法:
- 在2017年1月至2022年12月期间,从325名接受胰腺二切除术 (n=253) 或远端胰腺切除术 (n=72) 的患者收集前性数据.
- 在手术期间放置排水管,并根据手术后的一天和氨酶水平进行去除.
- 对于高粉酶或可疑的囊,按需启动排水灌;非排水的收集物通过皮肤或内镜进行管理.
主要成果:
- 临床相关的胰腺囊发生在16.3% (B级) 和1.2% (C级) 的患者中.
- 排水灌在43.3%的抽病例中使用;5.8%需要额外的干预.
- 与和出血相关的重新手术率为1.5%;30天死亡率为1.5%.
结论:
- 在胰腺切除术中,标准化的排水协议与按需灌导致了与关联的低发病率和死亡率.
- 与先前的研究相比,对干预或手术重新干预的需求是罕见的.
- 这种方法在胰腺手术中表现出了有利的结果.
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