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经过全胰腺切除术与小岛自移植后,结石风险增加
Nandini Avula1, James S Hodges2, Gregory Beilman3
1University of Minnesota Medical School, Minneapolis, MN, USA.
概括
患有慢性胰腺炎 (CP) 的患者接受了全胰腺切除与小岛自移植 (TPIAT) 时,患结石的风险很大. 近30%的人在15年内经历石头发作,需要提高临床意识和患者咨询以预防.
科学领域:
- 胃肠病学和肝病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术瘤学手术瘤学
背景情况:
- 慢性胰腺炎 (CP) 与较高的氧酸结石发病率有关,通常是由于肠道高氧化尿.
- 在CP患者的全胰腺切除术与小岛自身移植 (TPIAT) 后,结石形成的风险在很大程度上仍未被描述.
研究的目的:
- 调查和量化TPIAT后CP患者结石发育的风险.
- 为了确定与TPIAT后结石形成相关的临床因素.
主要方法:
- 对接受TPIAT的629名患者的回顾性分析.
- 卡普兰-梅尔分析估计了第一次结石事件的时间.
- 安德森-吉尔比例危险分析以确定与结石发展的关联.
主要成果:
- 在TPIAT后,结石的累计发病率为5年12.8%,10年23.2%和15年29.4%.
- 显著的危险因素包括年龄较大,吸烟史,轻度慢性病,囊,以前的结石,结石家族史和Roux-en-Y重建.
- 在77名患有石头的患者中,44.1%的人有复发发作,而20.3%的石头总发作缺乏关于解决或去除的数据.
结论:
- 结石形成是TPIAT后CP患者的常见并发症,其中很大一部分患者在15年内形成结石.
- 医疗保健提供者应主动向患者提供关于结石风险和TPIAT后的预防策略的建议.
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