印度胰十二指肠切除术的围手术期结果：一项多中心研究。
Peri-operative outcomes for pancreatoduodenectomy in India: a multi-centric study.
出版信息
HPB (Oxford). 2009 Dec;11(8):638-44. doi: 10.1111/j.1477-2574.2009.00105.x.
BACKGROUND
There have been an increasing number of reports world-wide relating improved outcomes after pancreatic resections to high volumes thereby supporting the idea of centralization of pancreatic resectional surgery. To date there has been no collective attempt from India at addressing this issue. This cohort study analysed peri-operative outcomes after pancreatoduodenectomy (PD) at seven major Indian centres.
MATERIALS AND METHODS
Between January 2005 and December 2007, retrospective data on PDs, including intra-operative and post-operative factors, were obtained from seven major centres for pancreatic surgery in India.
RESULTS
Between January 2005 and December 2007, a total of 718 PDs were performed in India at the seven centres. The median number of PDs performed per year was 34 (range 9-54). The median number of PDs per surgeon per year was 16 (range 7-38). Ninety-four per cent of surgeries were performed for suspected malignancy in the pancreatic head and periampullary region. The median mortality rate per centre was four (range 2-5%). Wound infections were the commonest complication with a median incidence per centre of 18% (range 9.3-32.2%), and the median post-operative duration of hospital stay was 16 days (range 4-100 days).
CONCLUSIONS
This is the first multi-centric report of peri-operative outcomes of PD from India. The results from these specialist centers are very acceptable, and appear to support the thrust towards centralization.
背景
全球范围内越来越多的报告表明，胰腺切除术的高手术量与改善结果有关，从而支持胰腺切除术集中化的观点。迄今为止，印度尚未对此问题进行过集体探讨。本队列研究分析了印度 7 个主要中心进行胰十二指肠切除术（PD）的围手术期结果。
材料与方法
2005 年 1 月至 2007 年 12 月期间，从印度 7 个主要胰腺外科中心获取了包括术中及术后因素在内的 PD 回顾性数据。
结果
2005 年 1 月至 2007 年 12 月期间，印度 7 个中心共进行了 718 例 PD。每年 PD 的中位数为 34 例（范围 9-54 例）。每年每位外科医生的 PD 中位数为 16 例（范围 7-38 例）。94%的手术是为胰腺头部和胰周区域的可疑恶性肿瘤而进行的。各中心的中位死亡率为 4%（范围 2-5%）。伤口感染是最常见的并发症，各中心的中位数发生率为 18%（范围 9.3-32.2%），术后住院时间的中位数为 16 天（范围 4-100 天）。
结论
这是印度首次多中心报道 PD 的围手术期结果。这些专科中心的结果非常令人满意，似乎支持集中化的趋势。
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