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日本多中心前瞻性腹腔镜胰腺切除术注册研究: 1429 例评估报告。

A multicenter prospective registration study on laparoscopic pancreatectomy in Japan: report on the assessment of 1,429 patients.

机构信息

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2020 Feb;27(2):47-55. doi: 10.1002/jhbp.695. Epub 2019 Dec 11.

Abstract

BACKGROUND

Prospective studies are needed to understand the safety and feasibility of laparoscopic pancreatectomy. The aim of the present study was to describe laparoscopic pancreatectomy currently undertaken in Japan, using a prospective registration system.

METHODS

Patient characteristics and planned operations were registered preoperatively, and then the performed operation and outcomes were reported using an online system. Collected data were also compared between institutions based on their level of experience. This study was registered with UMIN000022836.

RESULTS

Available data were obtained from 1,429 patients at 100 Japanese institutions, including 1,197 laparoscopic distal pancreatectomies (LDPs) and 232 laparoscopic pancreatoduodenectomies (LPDs). The rates of completion for planned operations were 92% for LDP and 91% for LPD. Postoperative complication rates after LDP and LPD were 17% and 30%, and 90-day mortality rates were 0.3% and 0.4%, respectively. Shorter operation time, less blood loss, and lower incidence of pancreatic fistula were observed in institutions experienced in LDP. A higher rate of pure laparoscopic procedure and shorter operation time were noted in institutions experienced with LPD.

CONCLUSION

LDPs and LPDs are performed safely in Japan, especially in experienced institutions. Our data could support the next challenges in the field of laparoscopic pancreatectomy.

摘要

背景

需要前瞻性研究来了解腹腔镜胰腺切除术的安全性和可行性。本研究旨在使用前瞻性注册系统描述目前在日本进行的腹腔镜胰腺切除术。

方法

患者特征和计划手术在术前进行登记,然后使用在线系统报告实际进行的手术和结果。根据经验水平,还比较了各机构之间收集的数据。本研究在 UMIN000022836 进行了注册。

结果

从日本 100 家机构的 1429 名患者中获得了可用数据,包括 1197 例腹腔镜胰体尾切除术(LDP)和 232 例腹腔镜胰十二指肠切除术(LPD)。计划手术的完成率分别为 LDP 92%和 LPD 91%。LDP 和 LPD 后的术后并发症发生率分别为 17%和 30%,90 天死亡率分别为 0.3%和 0.4%。在有经验的机构中,LDP 的手术时间更短、出血量更少、胰瘘发生率更低。在有经验的机构中,LPD 的纯腹腔镜手术比例更高,手术时间更短。

结论

LDP 和 LPD 在日本安全实施,尤其是在有经验的机构中。我们的数据可以为腹腔镜胰腺切除术领域的下一步挑战提供支持。

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