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布伦加特胰肠吻合术:安全性和结果分析。

Blumgart's technique of pancreaticojejunostomy: Analysis of safety and outcomes.

机构信息

Department of Surgical Gastroenterology, King George's Medical University, Lucknow 226003, Uttar Pradesh, India.

Department of Human Organ Transplant, King George's Medical University, Lucknow 226003, Uttar Pradesh, India.

出版信息

Hepatobiliary Pancreat Dis Int. 2019 Apr;18(2):181-187. doi: 10.1016/j.hbpd.2019.01.007. Epub 2019 Jan 31.

Abstract

BACKGROUND

Blumgart's pancreaticojejunostomy (PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes.

METHODS

We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula (CR-POPF) and analysis of its risk factors.

RESULTS

The CR-POPF rate was 12.3%. Fistula risk score (FRS) was the only significant risk factor for the occurrence of overall POPF in multivariate analysis. However, none of the other factors including FRS was found to be significantly associated with CR-POPF risk. A strong positive correlation was found between the CR-POPF and the incidence of delayed gastric emptying, post-pancreatectomy hemorrhage and increased length of hospital stay.

CONCLUSION

Blumgart's technique is a safe technique of pancreatico-enteric anastomosis with low rates of CR-POPF. CR-POPF with this technique is independent of most of the preoperative and intraoperative factors. Therefore, this technique can be used for all types of the pancreas with consistently good results.

摘要

背景

布伦加特胰肠吻合术(PJ)具有较低的胰漏发生率。本研究旨在评估我们应用该技术的经验,包括胰漏和其他围手术期结果。

方法

我们对 2011 年 1 月至 2018 年 2 月期间在我科行胰十二指肠切除术的 81 例患者进行了单中心回顾性分析。主要终点是发生临床相关的术后胰瘘(CR-POPF)及其危险因素分析。

结果

CR-POPF 发生率为 12.3%。多因素分析显示,胰瘘风险评分(FRS)是总体 POPF 发生的唯一显著危险因素。然而,包括 FRS 在内的其他因素与 CR-POPF 风险均无显著相关性。CR-POPF 与胃排空延迟、胰周出血和住院时间延长的发生率呈正相关。

结论

布伦加特技术是一种安全的胰肠吻合技术,CR-POPF 发生率低。该技术的 CR-POPF 与大多数术前和术中因素无关。因此,该技术可用于所有类型的胰腺,均能获得良好的效果。

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