胆汁暴露时间对胰十二指肠切除术后器官/间隙外科部位感染的影响。
Impact of Bile Exposure Time on Organ/space Surgical Site Infections After Pancreaticoduodenectomy.
机构信息
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
出版信息
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.
PATIENTS AND METHODS
Sixty-one patients who underwent pancreaticoduodenectomy were retrospectively studied. The impact of perioperative variables and BE time on organ/space SSI occurrence was analyzed.
RESULTS
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.
CONCLUSION
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。
患者和方法
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。
结果
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。
结论
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。
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