Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, P.O. Box 01307, Dresden, Germany.
Institute and Polyclinic for Diagnostic and Interventional Radiology, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, P.O. Box 01307, Dresden, Germany.
Langenbecks Arch Surg. 2021 May;406(3):893-902. doi: 10.1007/s00423-020-02009-4. Epub 2020 Oct 9.
Postoperative pulmonary embolism (PE) after pancreatic surgery is a potentially life-threatening complication. However, the magnitude of morbidity and mortality of PE is still uncertain. The present study aims to assess the incidence of PE after pancreatic surgery and analyze its impact on the outcome.
We conducted a retrospective study including all patients who underwent pancreatic resections between 2005 and 2017. The development of PE was analyzed for a 90-day period following surgery. Risk factors were evaluated using regression models.
The study investigated 947 patients undergoing pancreatic surgery. Overall, 26 (2.7%) patients developed PE. The median body mass index (BMI) of patients with PE was significantly higher (28.1 kg/m [24.7-31.8] vs. 24.8 kg/m [22.4-27.8], p < 0.001). Patients with PE had a significantly increased duration of the operation and more often underwent multivisceral resections. The lowest incidence of PE was found after distal or total pancreatectomy (2%). In median, PE occurred on the fifth postoperative day (interquartile range: 3-9). Increased BMI, duration of operation, and postoperative deep venous thrombosis were found to be multivariate risk factors for the development of PE. Importantly, postoperative complications (53.8% vs. 15.1%, p < 0.001) and the 30-day mortality rate were significantly increased in the PE group (19.2% vs. 3.3%, p < 0.001).
Patients with increased BMI, a history of deep venous thrombosis, and multivisceral resections are a high-risk group for PE after pancreatic surgery. While the absolute incidence and related mortality of PE after pancreatic surgery is low, it is associated with severe sequelae.
胰腺手术后的肺栓塞（PE）是一种潜在的危及生命的并发症。然而，PE 的发病率和死亡率仍不确定。本研究旨在评估胰腺手术后 PE 的发生率，并分析其对结局的影响。
我们进行了一项回顾性研究，纳入了 2005 年至 2017 年间接受胰腺切除术的所有患者。术后 90 天内分析 PE 的发生情况。使用回归模型评估危险因素。
研究共纳入 947 例行胰腺手术的患者。总体而言，26 例（2.7%）患者发生了 PE。PE 患者的中位体重指数（BMI）显著较高（28.1kg/m [24.7-31.8] 比 24.8kg/m [22.4-27.8]，p<0.001）。PE 患者的手术时间明显延长，更常进行多脏器切除术。远端或全胰切除术的 PE 发生率最低（2%）。中位数 PE 发生在术后第 5 天（四分位间距：3-9）。增加的 BMI、手术时间和术后深静脉血栓形成被发现是 PE 发生的多变量危险因素。重要的是，PE 组术后并发症（53.8%比 15.1%，p<0.001）和 30 天死亡率（19.2%比 3.3%，p<0.001）显著增加。
BMI 增加、深静脉血栓形成病史和多脏器切除术的患者是胰腺手术后发生 PE 的高危人群。尽管胰腺手术后 PE 的绝对发生率和相关死亡率较低，但它与严重的后遗症相关。
