大型胰腺切除后的切口:从两个不同的来源进行长期风险评估 - 一个大型的多机构网络和一个单一的高体积中心
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Updated: Jun 12, 2025
00:13
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
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Nitzan Zohar1, Eliyahu Gorgov1, Theresa P Yeo1
1Jefferson Pancreas, Biliary and Related Cancer Centre, Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
概括
手术后的切口 (IH) 发生在11.0%的胰腺管切除术患者和8.6%的远端胰腺切除术患者中. 较高的BMI和感染增加了胰腺大手术后的IH风险.
科学领域:
- 腹部外科手术 腹部外科手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 手术后的切口 (IH) 是腹部手术后的常见并发症.
- 大型胰腺手术后IH发生率的数据很少.
- 胰腺切除后的生存率增加需要了解像IH这样的长期并发症.
研究的目的:
- 评估大胰腺手术后切口 (IH) 的长期风险.
- 为了确定与胰腺双管切除术 (PD) 和远部胰腺切除术 (DP) 后IH发展相关的风险因素.
主要方法:
- 这是一项双重方法研究,结合了多机构研究网络 (RN) 分析和患者报告的结果.
- 倾向性得分匹配的PD和DP幸存者被分析到IH发病率和风险因素.
- 一个患者问卷评估了较小队列中的IH发生率和相关因素.
主要成果:
- 在RN分析中,包括22,113名患者;IH发生在11.0%的PD患者和8.6%的PD患者中.
- 开放式手术,BMI>35和术后腹内感染是PD和DP中IH的显著风险因素.
- 患者调查 (n=104) 显示,15%报告了IH,BMI≥30,手术部位感染 (SSI) 和腹部内与风险增加有关.
结论:
- 在重大胰腺手术的幸存者中观察到长期切口 (IH) 的显著率.
- 识别和管理诸如肥胖和感染等风险因素对于降低IH患病率至关重要.
- 改善手术结果需要专注于缓解长期后果,如切口.
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