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在胰腺二切除术后食结肠切除术:益处还是负担?
Gilbert Samuel Jebakumar1, Siddhesh Tasgaonkar1, Jeevanandham Muthiah1
1Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.
Annals of hepato-biliary-pancreatic surgery
|June 17, 2025
概括
在胰腺二管切除术 (PD) 后,常规食结肠切除术 (FJ) 会增加延迟胃排空 (DGE) 和并发症. 省略常规的FJ可能会改善PD手术后的患者结果.
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:
- 胰腺双管切除术 (PD) 是胰腺头部,囊,偏远胆道和十二指肠瘤的标准.
- 延迟胃排空 (DGE) 是一种常见的PD并发症.
- 讨论了食脊髓切除术 (FJ) 对PD发病率,特别是DGE的必要性和影响.
研究的目的:
- 评估PD患者的早期术后结果.
- 为了比较FJ和没有FJ的PD患者之间的DGE和相关并发症.
- 为了确定影响PD后DGE的因素.
主要方法:
- 预期观察性研究 (2022年8月 - 2024年4月).
- 56名患者:28名患有FJ,28名没有FJ.
- 主要结局:DGE,手术后胰腺 (POPF),住院.
主要成果:
- 在FJ组中,DGE显著更高 (78.6%对39.3%,p=0.006).
- 临床相关的DGE (等级B/C) 与FJ更频繁 (60.7%对21.4%,p=0.008).
- FJ组的固体食物耐受性和住院时间更长;10.7%的FJ相关并发症.
结论:
- 在PD中常规的FJ与增加的DGE和管道并发症有关.
- 对FJ进行选择性的治疗方法可能会改善术后恢复.
- 需要进行更多的多中心试验,以制定用于PD的FJ使用指南.
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