He Ke-Ji, Jiao Xing-Yuan, Yang Xue-Wei, Hu Yi-Ze
Department of Hepatobiliary Surgery, Gansu Provincial Tumor Hospital, Lanzhou, Gansu, PR China.
Ai Zheng. 2008 Jan;27(1):75-7.
BACKGROUND & OBJECTIVE: Pancreatoduodenectomy is the main treatment for pancreatic carcinoma and periampullary carcinoma. This study was to explore risk factors of postoperative complications of pancreatoduodenectomy for pancreatic carcinoma and periampullary carcinoma.
Clinical data of 94 patients with pancreatic carcinoma or periampullary carcinoma, underwent pancreatoduodenectomy at the second affiliated hospital of Guangzhou Medical Collage and Gansu Provincial Tumor Hospital from Jan. 1993 to Nov. 2006, were analyzed. Thirteen clinicopathologic factors that could possibly influence postoperative mortality and morbidity were selected for univariate analysis and multivariate analysis using Cox proportional hazards model.
Univariate analysis showed that major risk factors of postoperative mortality and morbidity of the patients were total serum bilirubin level, serum album level, duration of jaundice, decompression of jaundice, operating time, intra-operative bleeding, and depth of tumor invasion (P<0.05). Multivariate analysis showed that intra-operative bleeding, operating time, total serum bilirubin level, and duration of jaundice were independent risk factors (P<0.01).
Postoperative mortality and morbidity of pancreatoduodenectomy for periampullary carcinoma are closely related to intra-operative bleeding, operating time, serum bilirubin level and duration of jaundice.
胰十二指肠切除术是胰腺癌和壶腹周围癌的主要治疗方法。本研究旨在探讨胰腺癌和壶腹周围癌行胰十二指肠切除术后并发症的危险因素。
分析1993年1月至2006年11月在广州医学院第二附属医院和甘肃省肿瘤医院行胰十二指肠切除术的94例胰腺癌或壶腹周围癌患者的临床资料。选取13个可能影响术后死亡率和发病率的临床病理因素，采用Cox比例风险模型进行单因素分析和多因素分析。
单因素分析显示，患者术后死亡率和发病率的主要危险因素为血清总胆红素水平、血清白蛋白水平、黄疸持续时间、黄疸减压情况、手术时间、术中出血及肿瘤浸润深度（P<0.05）。多因素分析显示，术中出血、手术时间、血清总胆红素水平和黄疸持续时间是独立危险因素（P<0.01）。
壶腹周围癌胰十二指肠切除术后的死亡率和发病率与术中出血、手术时间、血清胆红素水平和黄疸持续时间密切相关。
