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在治疗腹膜转移后的严重术后胰腺炎
1Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, DC, USA.
概括
严重的术后胰腺炎是腹部上部手术后的罕见但严重的并发症,特别是带有高温腹腔内化疗 (HIPEC) 的细胞减小手术 (CRS). 早期诊断和管理对于改善患者的治疗结果至关重要.
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:
- 手术后胰腺炎是腹部上部手术的罕见但严重的并发症.
- 原因包括直接创伤,导管损伤,血管损害或十二指肠停滞.
- 它与显著的发病率和死亡率有关.
研究的目的:
- 确定和分析经过细胞还原性手术 (CRS) 加上高热性腹腔内化疗 (HIPEC) 后出现严重术后胰腺炎的患者的临床特征和结果.
- 为接受重大CRS的患者的术后管理提供见解.
主要方法:
- 一个对1200名接受CRS和HIPEC/EPIC治疗的患者数据库的回顾性审查.
- 鉴定患有严重手术后胰腺炎的迹象和症状的患者.
- 详细的图表审查以确认诊断并收集临床和组织学数据.
主要成果:
- 在1200名患者中,12名患者 (1.0%) 患有严重的术后胰腺炎.
- 83.3%的患者接受了小囊膜切除术,66.6%的患者需要重新手术.
- 58.3%的患者出现了道泄漏;10.3%的胃切除术患者出现了胰腺炎.
- 平均住院时间为62天,术后死亡率为16.6%.
结论:
- 严重的术后胰腺炎是CRS和HIPEC后的重大并发症,在本系列患者中发生在1.0%的患者中.
- 在受影响的患者中观察到高的重复手术率和静脉漏.
- 怀疑的高指数对于早期诊断和管理至关重要,以改善结果.
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