Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
In Vivo. 2019 Sep-Oct;33(5):1553-1557. doi: 10.21873/invivo.11636.
BACKGROUND/AIM: Organ/space surgical site infections (SSIs) are critical complications of pancreaticoduodenectomy. We investigated the impact of the time between division of the common hepatic duct and completion of biliary reconstruction [bile exposure (BE) time] on the occurrence of post-pancreaticoduodenectomy organ/space SSI.
Sixty-one patients who underwent pancreaticoduodenectomy were retrospectively studied. The impact of perioperative variables and BE time on organ/space SSI occurrence was analyzed.
Organ/space SSIs occurred in 17 patients (28%). Patients were divided into two groups according to BE time. The incidence of organ/space SSIs was significantly higher in the long BE time group than in the short BE time group (42% versus 13%, p=0.0127). Multivariate analysis revealed that long BE times [odds ratio (OR)=4.8; p=0.0240] and soft pancreatic texture (OR=16.5; p=0.0106) were independent risk factors for organ/space SSIs.
Long BE time is a risk factor for post-pancreaticoduodenectomy organ/space SSIs. Shortening BE time may reduce organ/space SSI occurrence.
背景/目的：器官/腔隙外科部位感染（SSI）是胰十二指肠切除术的严重并发症。我们研究了肝总胆管分离与胆道重建完成之间的时间（胆汁暴露[BE]时间）对胰十二指肠切除术后器官/腔隙 SSI 发生的影响。
回顾性研究了 61 例接受胰十二指肠切除术的患者。分析了围手术期变量和 BE 时间对器官/腔隙 SSI 发生的影响。
17 例（28%）患者发生器官/腔隙 SSI。根据 BE 时间将患者分为两组。长 BE 时间组的器官/腔隙 SSI 发生率明显高于短 BE 时间组（42%比 13%，p=0.0127）。多变量分析显示，长 BE 时间[比值比（OR）=4.8；p=0.0240]和软胰腺质地（OR=16.5；p=0.0106）是器官/腔隙 SSI 的独立危险因素。
长 BE 时间是胰十二指肠切除术后器官/腔隙 SSI 的危险因素。缩短 BE 时间可能会降低器官/腔隙 SSI 的发生。
