术前机械性肠道准备对接受胰十二指肠切除术的患者无益。

Preoperative mechanical bowel preparation does not offer a benefit for patients who undergo pancreaticoduodenectomy.

机构信息

Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.

出版信息

Surgery. 2010 Aug;148(2):278-84. doi: 10.1016/j.surg.2010.03.012. Epub 2010 May 5.

DOI:10.1016/j.surg.2010.03.012

PMID:20447669

Abstract

BACKGROUND

Mechanical bowel preparations (MBPs) are commonly administered preoperatively to patients who undergo pancreaticoduodenectomy (PD); however, their effectiveness over a clear liquid diet (CLD) preparation remains unclear. The aim of this study was to determine whether MBP offers an advantage to patients who undergo PD.

METHODS

In this retrospective review, we analyzed the clinical data from 100 consecutive PDs performed on patients who received preoperative MBP from March 2006 to April 2007, and we compared them with 100 consecutive patients who received a preoperative CLD from May 2007 to March 2008.

RESULTS

No differences were observed between the MBP and CLD groups in the rates of pancreatic fistula (13% vs 14%; P = 1.0), intra-abdominal abscess (11% vs 13%; P = .83), or wound infection (9% vs 8%; P = 1.0). Trends toward increased urinary tract infections (13% vs 5%; P < .08) and Clostridium difficile infections were found in the MBP group (6% vs 1%; P = .12). The median duration of postoperative hospital stay was 7 days in each group, and the 12-month survival rates were equivalent (74% vs 75%; P = 1.0).

CONCLUSION

There is no clinical benefit to the administration of a preoperative MBP for patients undergoing PD.

摘要

背景

机械肠道准备（MBP）常用于接受胰十二指肠切除术（PD）的患者，但术前给予 MBP 相对于清流质饮食（CLD）准备的效果尚不清楚。本研究旨在确定 MBP 是否对接受 PD 的患者有益。

方法

本回顾性研究分析了 2006 年 3 月至 2007 年 4 月期间接受术前 MBP 的 100 例 PD 患者的临床数据，并与 2007 年 5 月至 2008 年 3 月期间接受术前 CLD 的 100 例连续患者进行比较。

结果

MBP 组与 CLD 组在胰瘘发生率（13% vs 14%；P = 1.0）、腹腔脓肿发生率（11% vs 13%；P =.83）或伤口感染发生率（9% vs 8%；P = 1.0）方面无差异。MBP 组尿路感染（13% vs 5%；P <.08）和艰难梭菌感染的趋势增加（6% vs 1%；P =.12）。每组患者的术后住院时间中位数均为 7 天，12 个月生存率相当（74% vs 75%；P = 1.0）。