Jung Gun Hee, Hwang Ho Kyoung, Lee Woo Jung, Kang Chang Moo
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Ann Hepatobiliary Pancreat Surg. 2019 Nov;23(4):377-384. doi: 10.14701/ahbps.2019.23.4.377. Epub 2019 Nov 29.
BACKGROUNDS/AIMS: Distal pancreatectomy(DP) is associated with high morbidity. In clinical practice, postoperative white blood cell(WBC) counts are useful indicators of infection complications. The aim of this study was to determine the relevance of extremely high postoperative day (POD)1 WBC counts after DP and their relationship to perioperative outcomes.
From December 2005 to December 2016, data from patients who had open or minimally invasive DP surgery (robot or laparoscopy, MIS) for benign or borderline malignant tumors were retrospectively reviewed. Patients were divided into groups based on POD1 WBC count (>20K, High and <20K, Low) for comparisons.
Twelve patients (4.6%) were categorized into the High group. There were significant differences in age (=0.019), BMI (=0.010), and spleen-preserving rate (=0.002) between the High and Low groups. In binary logistic regression analysis, the risk factors for severe complication was age (=0.032) and open DP (=0.005), not POD1 WBC count.
Extremely high WBC count after POD1 after DP was not associated with severe complications, but was associated with splenectomy. Surgical methods and age were associated with severe complications.
背景/目的：胰体尾切除术（DP）与高发病率相关。在临床实践中，术后白细胞（WBC）计数是感染并发症的有用指标。本研究的目的是确定DP术后第1天（POD1）白细胞计数极高的相关性及其与围手术期结果的关系。
回顾性分析2005年12月至2016年12月期间因良性或交界性恶性肿瘤接受开放或微创DP手术（机器人或腹腔镜手术，MIS）的患者数据。根据POD1白细胞计数（>20K，高；<20K，低）将患者分组进行比较。
12例患者（4.6%）被归入高组。高组和低组在年龄（=0.019）、体重指数（=0.010）和保脾率（=0.002）方面存在显著差异。在二元逻辑回归分析中，严重并发症的危险因素是年龄（=0.032）和开放DP手术（=0.005），而非POD1白细胞计数。
DP术后POD1白细胞计数极高与严重并发症无关，但与脾切除术有关。手术方式和年龄与严重并发症有关。
