Madureira Fábio Athayde Veloso, Grès Philippe, Vasques Rodrigo Rodrigues, Levard Hugues, Randone Bruto, Gayet Brice
Institut Mutualiste Montsouris, Paris, France.
Rev Col Bras Cir. 2012 Dec;39(6):496-501. doi: 10.1590/s0100-69912012000600009.
To evaluate the postoperative morbidity of distal pancreatic resections and to investigate its predictive factors.
The study was conducted retrospectively from a prospectively database maintained. From 1994 to 2008, 100 consecutive patients underwent left pancreatic resections. The primary variable of interest was postoperative morbidity, and various other characteristics of the population were simultaneously recorded. Later, for the analysis of predictors of postoperative morbidity, the subgroup of patients who underwent distal pancreatectomy with spleen preservation (n = 65) was separately analyzed with regards to the different techniques of section of the pancreatic parenchyma, as well as to other possible predictors of postoperative morbidity.
Considering all left pancreatic resections performed, the occurrence of overall, relevant and serious complications was 55%, 42% and 20%, respectively. The factors predictive of postoperative morbidity after distal pancreatectomy with spleen preservation were the technique employed for section of the pancreatic parenchyma, age, body mass index and the performance of concomitant abdominal operations.
The morbidity associated with pancreatic resections to the left of the superior mesenteric vessels was high. According to the stratification adopted based on the severity of complications, some predictive factors have been identified. Future studies with larger cohorts of patients are needed to confirm these results.
评估远端胰腺切除术的术后发病率,并探究其预测因素。
本研究是对前瞻性维护的数据库进行回顾性研究。1994年至2008年,连续100例患者接受了左胰腺切除术。主要关注变量为术后发病率,同时记录了该人群的各种其他特征。之后,为分析术后发病率的预测因素,对保留脾脏的远端胰腺切除术患者亚组(n = 65),就胰腺实质切断的不同技术以及术后发病率的其他可能预测因素进行了单独分析。
考虑到所有实施的左胰腺切除术,总体、相关及严重并发症的发生率分别为55%、42%和20%。保留脾脏的远端胰腺切除术后预测术后发病率的因素包括胰腺实质切断所采用的技术、年龄、体重指数以及同期腹部手术的实施情况。
肠系膜上血管左侧胰腺切除术相关的发病率较高。根据基于并发症严重程度采用的分层方法,已确定了一些预测因素。需要更大患者队列的未来研究来证实这些结果。