胰十二指肠切除术后胃排空延迟：Roux-en-Y 胃空肠吻合术与 Billroth II 胃空肠吻合术的随机研究。

Delayed gastric emptying following pancreatoduodenectomy: a Roux-en-Y gastrojejunostomy vs Billroth II gastrojejunostomy randomized study.

机构信息

Complejo Hospitalario de Navarra.

Cirugía General, Complejo Hospitalario de Navarra, España.

出版信息

Rev Esp Enferm Dig. 2019 Jan;111(1):34-39. doi: 10.17235/reed.2018.5744/2018.

DOI:10.17235/reed.2018.5744/2018

PMID:30284910

Abstract

INTRODUCTION

delayed gastric emptying (DGE) is the most common complication after pancreaticoduodenectomy (PD) and it occurs in 50% of cases.

OBJECTIVES

the endpoint was to determine if there were any differences in the incidence of DGE between Roux-en-Y gastrojejunostomy (ReY) and Billroth II gastrojejunostomy (BII) in PD with pancreaticogastrostomy (PG).

METHODS

this was a case-control prospective randomized study of all PD cases between 2013 and 2016. Sixty-four patients were included, 32 in each group. An intention-to-treat statistical analysis was performed.

RESULTS

no significant differences were found with regard to morbidity and mortality or hospital stay. DGE was present in 25% of the patients in the BII group in comparison to 15.6% in the ReY group, which was not statistically significant (p = 0.35). There was a higher percentage of patients with primary DGE in the BII group, 12.5% versus 6.2%, but this was not statistically significant (p = 0.53). No difference in DGE severity was observed. Male gender (OR 8.38 [1.1; 129]), abdominal complications (OR 15 [1.7; 396.9]), pre-operative malnutrition (OR 99.7 [3.3, 11,126]) and hemorrhage (OR 9.4 [1.37, 107.94]) were the main risk factors for DGE according to the multivariate analysis.

CONCLUSIONS

there were no significant differences in the incidence or severity of DGE between BII or ReY after PD with PG.

摘要

介绍

胃排空延迟（DGE）是胰十二指肠切除术（PD）后最常见的并发症，发生率为 50%。

目的

本研究旨在确定在 PD 行胰胃吻合术（PG）时 Roux-en-Y 胃空肠吻合术（ReY）和 Billroth II 胃空肠吻合术（BII）之间 DGE 的发生率是否存在差异。

方法

这是一项 2013 年至 2016 年间所有 PD 病例的病例对照前瞻性随机研究。共纳入 64 例患者，每组 32 例。采用意向治疗的统计分析。

结果

两组在发病率、死亡率或住院时间方面无显著差异。BII 组中 DGE 的发生率为 25%，而 ReY 组为 15.6%，差异无统计学意义（p=0.35）。BII 组中原发性 DGE 的患者比例较高，为 12.5%，而 ReY 组为 6.2%，但差异无统计学意义（p=0.53）。两组 DGE 的严重程度无差异。多因素分析显示，男性（OR 8.38[1.1; 129]）、腹部并发症（OR 15[1.7; 396.9]）、术前营养不良（OR 99.7[3.3, 11,126]）和出血（OR 9.4[1.37, 107.94]）是 DGE 的主要危险因素。