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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 184 -186. doi: 10.3877/cma.j.issn.1674-3946.2022.02.018

论著

胰十二指肠切除术后胰瘘相关影响因素探究
罗金磊1, 候辉2, 赵文星3, 范彬1,()   
  1. 1. 234000 安徽宿州,宿州市第一人民医院普外一科
    2. 230621 合肥,安徽医科大学附属第二医院肝胆胰外科
    3. 221000 江苏徐州,徐州医科大学附属医院胰腺外科
  • 收稿日期:2021-06-16 出版日期:2022-04-26
  • 通信作者: 范彬

Influential factors of pancreatic leakage after pancreaticoduodenectomy

Jinlei Luo1, Hui Hou2, Wenxing Zhao3, Bin Fan1,()   

  1. 1. Department 1 of general surgery, Suzhou First People’s Hospital, Suzhou Anhui Province 234000, China
    2. Department of hepatobiliary and pancreatic surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui Province 230601, China
    3. Department of pancreatic surgery, Affiliated Hospital of Xuzhou Medical University, Xunzhou Jiangsu Province 221000, China
  • Received:2021-06-16 Published:2022-04-26
  • Corresponding author: Bin Fan
  • Supported by:
    The Natural Science Foundation of Anhui Province in 2020(2008085MA09)
引用本文:

罗金磊, 候辉, 赵文星, 范彬. 胰十二指肠切除术后胰瘘相关影响因素探究[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(02): 184-186.

Jinlei Luo, Hui Hou, Wenxing Zhao, Bin Fan. Influential factors of pancreatic leakage after pancreaticoduodenectomy[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(02): 184-186.

目的

探究胰十二指肠切除术后胰瘘发生的相关影响因素。

方法

回顾性分析2015年4月至2021年4月行传统开腹胰十二指肠切除术的130例患者临床资料,根据术后是否发生胰瘘分为胰瘘组(n=31)和对照组(n=99)。数据采用SPSS 16.0统计软件进行数据分析,计量资料采用(

xˉ
±s)表示,采用样本独立t检验;计数资料应用构成比表示,采用χ2检验,多因素采用非条件Logistic回归分析,以P<0.05为差异有统计学意义。

结果

130例胰十二指肠切除术患者,31例患者发生胰瘘,发生率为23.8%。两组单因素结果显示:术前胆红素、胰管直径、胰管支撑引流、胰腺质地比较差异有统计学意义(P<0.05)。多因素结果显示:胰管直径≥3 mm、胰管支撑引流、胰腺质地软是胰十二指肠切除术术后胰瘘的保护性指标。术前胆红素≥171 μmol/L是胰十二指肠切除术术后胰瘘的独立危险因素。

结论

术前降低血清胆红素水平、术中仔细操作、增加胰管支撑引流等措施,可能降低术后胰瘘的发生。

Objective

To explore the related influencing factors of pancreatic fistula after pancreaticoduodenectomy.

Methods

The clinical data of 130 patients who underwent pancreaticoduodenectomy from April 2015 to April 2021 were retrospectively analyzed. According to whether pancreatic fistula occurred after the operation,they were divided into pancreatic fistula group(n=31 cases)and(n=99 cases)control group. SPSS 16.0 statistical software was used for data analysis. Measurement data was expressed by(

xˉ
±s),and independent t test was used. Statistical data were expressed by χ2 test and non-conditional Logistic regression analysis. P<0.05 was considered as statistically significant difference.

Results

Pancreatic fistula occurred in 31 of 130 patients with pancreaticoduodenectomy(23.8%). Univariate results showed that there were statistically significant differences in preoperative bilirubin,pancreatic duct diameter,pancreatic duct drainage and pancreatic texture between the two groups(P<0.05). Multivariate results showed that pancreatic duct diameter ≥3 mm,supportive drainage of pancreatic duct and soft pancreatic texture were protective indicators of pancreatic fistula after pancreaticoduodenectomy. Preoperative bilirubin ≥171 μmol/L is an independent risk factor for pancreatic fistula after pancreaticoduodenectomy.

Conclusion

Preoperative reduction of serum bilirubin level,careful operation and increase of pancreatic duct drainage may reduce the incidence of postoperative pancreatic fistula.

表1 130例胰十二指肠切除术患者术后是否发生胰瘘两组单因素分析[(
xˉ
±s),例]
表2 胰十二指肠切除术患者术后胰瘘相关危险因素的多因素分析
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