Baker Todd A, Aaron Joshua M, Borge Marc, Pierce Kenneth, Shoup Margo, Aranha Gerard V
Division of Surgical Oncology, Department of Surgery, Stritch School of Medicine, Loyola University, Maywood, IL 60153, USA.
Am J Surg. 2008 Mar;195(3):386-90; discussion 390. doi: 10.1016/j.amjsurg.2007.12.026.
This study evaluated the role of interventional radiology (IR) procedures to manage complications after pancreaticoduodenectomy.
A retrospective review was made of the records of patients with postsurgical complications managed with IR.
Among the 440 patients reviewed, the mortality, morbidity and reoperation rates were 1.6%, 36%, and 2%, respectively. Complications occurred in 159 patients, of which 39 (25%) required > or = 1 IR procedures. Of those 39 patients, 72% underwent percutaneous drainage of an intra-abdominal abscess, 18% underwent percutaneous biliary drainage, and 10% underwent angiography for gastrointestinal bleeding or pseudoaneurysm. The reoperation rate among the 159 patients with complications was 6% (n = 9). Reoperation was avoided in 90% of patients receiving IR. Four patients underwent reoperation despite IR for persistent abscess, pancreatic fistula, anastomotic disruption, or mesenteric venous bleeding.
The majority of complications occurring after pancreaticoduodenectomy can be managed effectively using IR, thus minimizing morbidity and the need for reoperation.
本研究评估了介入放射学（IR）程序在处理胰十二指肠切除术后并发症中的作用。
对采用IR治疗的术后并发症患者的记录进行回顾性分析。
在440例接受评估的患者中，死亡率、发病率和再次手术率分别为1.6%、36%和2%。159例患者出现并发症，其中39例（25%）需要进行≥1次IR程序。在这39例患者中，72%接受了经皮腹腔脓肿引流，18%接受了经皮胆道引流，10%因胃肠道出血或假性动脉瘤接受了血管造影。159例有并发症的患者中再次手术率为6%（n = 9）。90%接受IR治疗的患者避免了再次手术。4例患者尽管接受了IR治疗，但仍因持续性脓肿、胰瘘、吻合口破裂或肠系膜静脉出血而接受了再次手术。
胰十二指肠切除术后发生的大多数并发症可通过IR有效处理，从而将发病率和再次手术的需求降至最低。
