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应用大网膜瓣覆盖肝创面预防左半肝切除术后胃排空延迟:一项前瞻性随机对照试验。

Using the greater omental flap to cover the cut surface of the liver for prevention of delayed gastric emptying after left-sided hepatobiliary resection: a prospective randomized controlled trial.

机构信息

Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2011 Mar;18(2):176-83. doi: 10.1007/s00534-010-0323-z.

Abstract

OBJECTIVE

The aim of this randomized controlled trial is to evaluate the effect on delayed gastric emptying (DGE) of using the greater omental flap to cover the cut surface of the liver after left-sided hepatobiliary resection.

METHODS

From June 2007 to December 2008, all eligible patients were randomly assigned to either the greater omental flap group (OF group) or the control group (non-OF group).

RESULTS

A total of 40 patients remained for final analysis. The incidence of DGE after left-sided hepatobiliary resection was 25%. The incidence of DGE showed no statistically significant differences between the OF group (10%) and the non-OF group (40%) (p = 0.065). The assessment of DGE using radiopaque rings revealed that changes over time in the gastric emptying ratio (GER, percentage of rings excreted from stomach) did not differ in a significant manner between the two groups. There were significant differences in changes over time in GER (p = 0.044) between the patients with and without DGE. The patients with DGE also showed higher GER at 5 h (p = 0.042) and at 6 h (p = 0.034) than those without DGE.

CONCLUSIONS

Using the greater omental flap to cover the cut surface of the liver may reduce the incidence of DGE after left-sided hepatobiliary resection. Assessment using radiopaque markers may be useful to evaluate DGE.

摘要

目的

本随机对照试验旨在评估使用大网膜瓣覆盖左肝胆切除术后肝切面,对延迟性胃排空(DGE)的影响。

方法

2007 年 6 月至 2008 年 12 月,所有符合条件的患者被随机分为大网膜瓣组(OF 组)或对照组(非 OF 组)。

结果

共有 40 例患者进入最终分析。左肝胆切除术后 DGE 的发生率为 25%。OF 组(10%)和非 OF 组(40%)的 DGE 发生率无统计学差异(p = 0.065)。使用不透射线环评估 DGE 时,两组胃排空率(GER,从胃中排出的环的百分比)随时间的变化无显著差异。有和无 DGE 的患者 GER 随时间的变化存在显著差异(p = 0.044)。DGE 患者的 GER 在 5 小时(p = 0.042)和 6 小时(p = 0.034)也高于无 DGE 的患者。

结论

使用大网膜瓣覆盖左肝胆切除术后肝切面可能会降低 DGE 的发生率。使用不透射线标志物评估可能有助于评估 DGE。

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