比较胰十二指肠切除术后行胰胃吻合术（PG）和胰肠吻合术（PJ）的结果。
Outcomes comparing a pancreaticogastrostomy (PG) and a pancreaticojejunostomy (PJ) after a pancreaticoduodenectomy (PD).
机构信息
Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK.
出版信息
HPB (Oxford). 2011 Oct;13(10):723-31. doi: 10.1111/j.1477-2574.2011.00363.x.
BACKGROUND
The advantage of a pancreaticogastrostomy (PG) over a pancreaticojejunostomy (PJ) after a pancreaticoduodenectomy (PD) is not clear.
AIM
The aim of the present study was to compare the pancreatic fistula (PF, defined according to the International Study Group for Pancreatic Fistula classification) rate and other complications between both methods.
METHODS
Retrospective analysis of prospectively collected data of 424 [median: 65 years (17-83)] patients who underwent PG (239, 56.4%) and PJ (185, 43.6%) reconstruction between January 2005 and December 2009.
RESULTS
PF occurred in 55 (23.5%) in the PG and 30 (16.2%, P= 0.067) patients in the PJ group. Grade A PF occurred in 19 (7.9%), B in 22 (9.2%) and C in 14 (5.8%) in the PG compared with 5 (2.7%), 12 (6.5%) and in 13 (7.0%), respectively, in the PJ group. The median hospital was 10 days in both groups. The morbidity was higher in the PG group (108, 45.2 vs. 62, 33.5%, P= 0.015). However, there was no significant difference in the 90-day mortality between both groups (PG-17, 7.0% vs. PJ-16, 8.6%, P= 0.558).
CONCLUSION
There was no difference in the overall PF rate, hospital stay and overall mortality between PG and PJ reconstruction methods. However, the grade A PF rate was higher in the PG group.
背景
胰十二指肠切除术后行胰胃吻合术（PG）优于胰肠吻合术（PJ），但这一优势尚不清楚。
目的
本研究旨在比较两种方法的胰瘘（PF，根据国际胰腺瘘研究组分类定义）发生率和其他并发症。
方法
回顾性分析了 2005 年 1 月至 2009 年 12 月期间行 PG（239 例，56.4%）和 PJ（185 例，43.6%）重建的 424 例[中位年龄：65 岁（17-83）]患者的前瞻性收集数据。
结果
PG 组 55 例（23.5%）和 PJ 组 30 例（16.2%，P=0.067）发生 PF。PG 组中 A 级 PF 为 19 例（7.9%），B 级为 22 例（9.2%），C 级为 14 例（5.8%），PJ 组分别为 5 例（2.7%），12 例（6.5%）和 13 例（7.0%）。两组的中位住院时间均为 10 天。PG 组的发病率较高（108 例，45.2% vs. 62 例，33.5%，P=0.015）。然而，两组 90 天死亡率无显著差异（PG 组 17 例，7.0% vs. PJ 组 16 例，8.6%，P=0.558）。
结论
PG 和 PJ 重建方法在总体 PF 率、住院时间和总体死亡率方面无差异。然而，PG 组的 A 级 PF 发生率较高。
Zotero 插件