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胆道支架置入术对接受胰腺切除术患者手术结局的影响。一项单中心回顾性研究。

Impact of biliary stenting on surgical outcome in patients undergoing pancreatectomy. A retrospective study in a single institution.

作者信息

Agalianos Christos, Paraskeva Konstantina, Gouvas Nikolaos, Davides Demetrios, Dervenis Christos

机构信息

Department of General Surgery, Konstantopouleion General Hospital, Athens, 14232, Greece.

Department of Gastroenterology, Konstantopouleion General Hospital, Athens, 14232, Greece.

出版信息

Langenbecks Arch Surg. 2016 Feb;401(1):55-61. doi: 10.1007/s00423-015-1360-5. Epub 2015 Nov 14.

Abstract

PURPOSE

There are conflicting views regarding preoperative biliary drainage in patients undergoing pancreatectomy. The aim of this study was to evaluate the effect of jaundice resolution on postoperative outcomes.

METHODS

Patients who underwent pancreatectomy in a single institution since 2010 were retrospectively analyzed. They were divided into two groups, depending on the presence or not of preoperative biliary drainage. Postoperative morbidity and mortality were evaluated.

RESULTS

Ninety-nine patients underwent biliary drainage by endoscopic retrograde cholangiopancreatography (ERCP) (PBD group), while 105 patients had no biliary drainage (non-PBD group). No significant difference between the two groups could be identified in terms of overall complications (p = 0.121) or mortality (p = 1). There was no significant difference regarding pancreatic fistula (p = 0.554), delayed gastric emptying (p = 0.127), hemorrhage (p = 0.426), number of reoperations (p = 1.000) or readmissions (p = 1.000). The only significant difference was found in the hospital stay, where patients who underwent preoperative biliary drainage had a prolonged length of stay of more 3 days (15.52 vs. 11.31) (p < 0.001).

CONCLUSION

Preoperative biliary drainage in patients undergoing pancreatectomy does not increase the rates of postoperative morbidity or mortality, but has a negative effect on hospital stay.

摘要

目的

对于接受胰腺切除术的患者,术前胆道引流存在相互矛盾的观点。本研究的目的是评估黄疸消退对术后结局的影响。

方法

对自2010年以来在单一机构接受胰腺切除术的患者进行回顾性分析。根据术前是否进行胆道引流将他们分为两组。评估术后发病率和死亡率。

结果

99例患者通过内镜逆行胰胆管造影术(ERCP)进行了胆道引流(PBD组),而105例患者未进行胆道引流(非PBD组)。两组在总体并发症(p = 0.121)或死亡率(p = 1)方面未发现显著差异。在胰瘘(p = 0.554)、胃排空延迟(p = 0.127)、出血(p = 0.426)、再次手术次数(p = 1.000)或再次入院率(p = 1.000)方面也没有显著差异。唯一的显著差异在于住院时间,术前进行胆道引流的患者住院时间延长超过3天(15.52天对11.31天)(p < 0.001)。

结论

接受胰腺切除术的患者术前胆道引流不会增加术后发病率或死亡率,但对住院时间有负面影响。

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