Xia Tao, Zhou Jia-Yu, Mou Yi-Ping, Xu Xiao-Wu, Zhang Ren-Chao, Zhou Yu-Cheng, Chen Rong-Gao, Lu Chao, Huang Chao-Jie
Department of Surgery, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Gastrointestinal-Pancreatic Surgery, Zhejiang Provincial Peoples' Hospital, Hangzhou, Zhejiang Province, China.
PLoS One. 2017 Feb 24;12(2):e0172857. doi: 10.1371/journal.pone.0172857. eCollection 2017.
Laparoscopic distal pancreatectomy (LDP) is a safe and reliable treatment for tumors in the body and tail of the pancreas. Postoperative pancreatic fistula (POPF) is a common complication of pancreatic surgery. Despite improvement in mortality, the rate of POPF still remains high and unsolved. To identify risk factors for POPF after laparoscopic distal pancreatectomy, clinicopathological variables on 120 patients who underwent LDP with stapler closure were retrospectively analyzed. Univariate and multivariate analyses were performed to identify risk factors for POPF. The rate of overall and clinically significant POPF was 30.8% and13.3%, respectively. Higher BMI (≥25kg/m2) (p-value = 0.025) and longer operative time (p-value = 0.021) were associated with overall POPF but not clinically significant POPF. Soft parenchymal texture was significantly associated with both overall (p-value = 0.012) and clinically significant POPF (p-value = 0.000). In multivariable analyses, parenchymal texture (OR, 2.933, P-value = 0.011) and operative time (OR, 1.008, P-value = 0.022) were risk factors for overall POPF. Parenchymal texture was an independent predictive factor for clinically significant POPF (OR, 7.400, P-value = 0.001).
腹腔镜远端胰腺切除术（LDP）是治疗胰腺体尾部肿瘤的一种安全可靠的方法。术后胰瘘（POPF）是胰腺手术的常见并发症。尽管死亡率有所改善，但POPF的发生率仍然很高且尚未解决。为了确定腹腔镜远端胰腺切除术后POPF的危险因素，对120例行LDP并使用吻合器闭合的患者的临床病理变量进行了回顾性分析。进行单因素和多因素分析以确定POPF的危险因素。总体POPF和具有临床意义的POPF发生率分别为30.8%和13.3%。较高的BMI（≥25kg/m2）（p值=0.025）和较长的手术时间（p值=0.021）与总体POPF相关，但与具有临床意义的POPF无关。胰腺实质质地柔软与总体POPF（p值=0.012）和具有临床意义的POPF（p值=0.000）均显著相关。在多变量分析中，实质质地（OR，2.933，P值=0.011）和手术时间（OR，1.008，P值=0.022）是总体POPF的危险因素。实质质地是具有临床意义的POPF的独立预测因素（OR，7.400，P值=0.001）。
