术前胆道引流对经典胰十二指肠切除术预后的影响。
Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy.
作者信息
Bhati Chandra Shekhar, Kubal Chandrashekhar, Sihag Pankaj Kumar, Gupta Ankur Atal, Jenav Raj Kamal, Inston Nicholas G, Mehta Jagdish M
机构信息
Upgraded Department of Surgery, SMS Medical College, Jaipur, India.
出版信息
World J Gastroenterol. 2007 Feb 28;13(8):1240-2. doi: 10.3748/wjg.v13.i8.1240.
AIM
To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticoduodenectomy.
METHODS
A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted.
RESULTS
Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable.
CONCLUSION
Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.
目的
探讨术前胆道引流（PBD）在经典胰十二指肠切除术中的作用。
方法
对1994年3月至2004年3月在印度斋浦尔SMS医学院外科接受胰十二指肠切除术的患者（n = 48）进行了为期10年的回顾性数据分析。记录人口统计学变量、术前支架置入细节、手术过程及术后并发症。
结果
21例患者（43.5%）进行了术前胆道引流。放置胆道支架的患者感染性并发症发生率显著更高（P < 0.05，0例对比4例）。该组患者的轻微胆漏率也显著更高。每组的死亡率和住院时间相当。
结论
在该研究人群中，通过内镜支架置入进行PBD与感染性并发症的高发生率相关。这些发现不支持在胰十二指肠切除术前行胆道支架置入的常规使用。
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