Adam Ulrich, Makowiec Frank, Riediger Hartwig, Schareck Wolfgang D, Benz Stefan, Hopt Ulrich T
Department of Surgery, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany.
Am J Surg. 2004 Feb;187(2):201-8. doi: 10.1016/j.amjsurg.2003.11.004.
Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period.
Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared.
Mortality was 3%. Overall and surgery-related complications occurred in 42% and 28%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [OR] 2.7), absence of preoperative biliary drainage (OR 1.9), and resection of other organs (OR 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period.
Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.
胰头切除术后的术后发病率很高。关于危险因素的数据存在争议。本研究的目的是评估胰头切除术后并发症的危险因素，并评估在研究期间并发症发生率是否发生变化。
前瞻性记录301例行胰头切除术患者的数据。通过多变量分析评估危险因素。比较研究期的第一部分和第二部分。
死亡率为3%。总体并发症和手术相关并发症分别发生在42%和28%。术后发病的独立危险因素是肾功能受损（比值比[OR]2.7）、术前未进行胆道引流（OR 1.9）和其他器官切除（OR 3.2）。在研究期间，并发症发生率、手术持续时间、输血量和住院时间均有所下降。
医院经验的增加降低了并发症发生率。对于有危险因素的患者，应考虑转至专科中心。
