Division of Digestive Surgery, Saku Central Hospital Advanced Care Center, Saku, Japan;
Division of Digestive Surgery, Saku Central Hospital Advanced Care Center, Saku, Japan.
In Vivo. 2021 Mar-Apr;35(2):1271-1276. doi: 10.21873/invivo.12378.
BACKGROUND/AIM: Useful prophylaxes of chyle leak (CL) after pancreatic surgery have not been established. The aim of the study was to identify an early clinical predictor for CL.
Fifty-five patients who underwent subtotal stomach preserved pancreaticoduodenectomy (SSPPD) were included. Clinical factors associated with postoperative CL were evaluated.
Eleven patients (20%) developed a CL after SSPPD. Shorter operative time, absent pancreatic fistula, and triglyceride output volume at postoperative day (POD) two were independent risk factors for CL. The receiver operating characteristics curve of the daily triglyceride output volume at POD two indicated a cut-off point of 177 mg (AUC=0.782; p=0.004; 95% CI=0.639-0.925). CL was significantly associated with prolonged postoperative hospital stay in patients who did not develop a pancreatic fistula (p=0.003).
Daily triglyceride output volume of >177 mg at POD two may be a predictor of CL following pancreaticoduodenectomy.
背景/目的：尚未确定胰腺手术后乳糜漏（CL）的有效预防措施。本研究的目的是确定 CL 的早期临床预测指标。
共纳入 55 例行保留部分胃的胰十二指肠切除术（SSPPD）的患者。评估了与术后 CL 相关的临床因素。
11 例（20%）患者在 SSPPD 后发生 CL。手术时间较短、无胰瘘以及术后第 2 天的甘油三酯输出量是 CL 的独立危险因素。术后第 2 天每日甘油三酯输出量的受试者工作特征曲线表明，截断值为 177mg（AUC=0.782；p=0.004；95%CI=0.639-0.925）。在未发生胰瘘的患者中，CL 与术后住院时间延长显著相关（p=0.003）。
术后第 2 天每日甘油三酯输出量>177mg 可能是胰十二指肠切除术后 CL 的预测指标。
