在透析依赖的患者中对Whipple程序进行比较结果分析:使用NSQIP数据进行倾向匹配的研究
Genia Dubrovsky1, Jiage Qian2, Sebastiaan Ceuppens3
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Surgical Services Division, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
概括
在透析患者的胰腺双管切除术 (PD) 增加了死亡率和一般并发症. 然而,像胰腺这样的PD特定问题没有显著不同,为手术决策提供了关键的见解.
科学领域:
- 手术瘤学手术瘤学
- 腎臟病學 (nephrology) 是一種醫學.
- 胃肠病学 胃肠病学
背景情况:
- 胰腺双管切除术 (PD) 是一项复杂的手术,由于高的外科手术风险,在透析患者的可行性存在争议.
- 调查透析对PD结果的影响对于患者管理至关重要.
研究的目的:
- 评估透析对术后并发症和胰腺除术后死亡率的影响.
- 为了比较透析和不透析患者之间的PD特异性并发症.
主要方法:
- 使用了NSQIP胰腺切除术数据库 (2014-2023年).
- 鉴定了接受PD的患者,123名透析患者与1:3的非透析患者相匹配.
- 分析了有关发病率,死亡率和PD特异性并发症的比较数据.
主要成果:
- 透析患者的整体并发症,再输管,心脏骤停和出血率较高 (p < 0.001).
- 透析组的30天死亡率明显高于透析组 (8.1%对3.0%,p=0.014).
- 胰腺的发病率,胃空气的延迟,以及排水的需要在各组之间没有差异.
结论:
- 透析患者接受PD面临死亡率和一般并发症的风险增加.
- 透析状态对PD特异性并发症没有显著影响.
- 发现有助于患者咨询和外科医生意识到透析患者的PD.
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