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胰腺切除术后的常规腹部排水:拜斯的元分析

Shengxiang Hou¹, Zonghao Hou¹, Li Ren^1,2

¹Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, P. R. China.

International journal of surgery (London, England)

|May 20, 2025

概括

胰腺切除术后的常规腹部排水会增加胰腺和再入院等并发症. 省略排水可能有利于患者,除了胰腺二切除术 (PD) 之后,它可以减少,但会增加死亡率.

科学领域:

胃肠病学和肝病学
手术瘤学手术瘤学
基于证据的医学基于证据的医学.

背景情况:

胰腺切除术后的并发症仍然是一个重大问题.
在胰腺手术后预防性腹部排水的作用受到争论.
优化手术技术以尽量减少发病率至关重要.

研究的目的:

系统地评估预防性腹部排水对胰腺切除术后并发症的影响.
为了比较胰腺切除术后的腹部排水和没有腹部排水的患者之间的结果.
为胰腺外科手术中排水策略提供基于证据的建议.

主要方法:

根据PRISMA指南,在多个数据库中进行了全面的系统文献搜索.
包括的研究比较了胰腺外科手术后的腹腔内排水与没有排水.
使用元分析技术进行了统计分析,包括对距离胰腺切除术 (DP) 和胰腺二切除术 (PD) 的子组分析.

主要成果:

常规的腹部排水与术后胰腺 (OR 2.46),临床相关的胰腺 (OR 1.92) 和未计划的再入院 (OR 1.32) 的显着较高率有关.
在远距离胰腺切除术小组中,排水增加了胰腺抽率 (OR 2.48-2.75).
对于胰腺二管切除术,排水减少了死亡率 (OR 0.49),但增加了胰腺抽率 (OR 1.95).

结论:

省略预防性排水可能有利于患者接受胰腺外科手术,除PD.
对于PD,虽然停止排水减少了,但它与死亡率的增加有关.
需要进一步的随机试验来比较常规与选择性排水策略.

关键词:

进行胰腺切除术.远端胰腺切除术是什么排水排水系统排水系统没有排水系统.胰腺切除术 (pancreaticoduodenectomy) 是一个切除术.

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