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急诊胰十二指肠切除术:一个非创伤中心的病例系列

Emergency Pancreatoduodenectomy: A Non-Trauma Center Case Series.

作者信息

Schlanger Diana, Popa Călin, Ciocan Andra, Șofron Cornelia, Al Hajjar Nadim

机构信息

Surgery Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania.

Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19-21, 400162 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2022 May 20;11(10):2891. doi: 10.3390/jcm11102891.

Abstract

(1) Background: Emergency pancreatoduodenectomy (EPD) is a rare procedure, especially in non-trauma centers. Pancreatoduodenectomy is a challenging intervention, that has even higher risks in emergency settings. However, EPD can be a life-saving procedure in selected cases. (2) Methods: Our study is a single-center prospective consecutive case series, on patients that underwent emergency pancreatoduodenectomies in our surgical department between January 2014 to May 2021. (3) Results: In the 7-year period, 4 cases were operated in emergency settings, out of the 615 patients who underwent PD (0.65%). All patients were male, with ages between 44 and 65. Uncontrollable bleeding was the indication for surgery in 3 cases, while a complex postoperative complication was the reason for surgery in one other case. In three cases, a classical Whipple procedure was performed, and only one case had a pylorus-preserving pancreatoduodenectomy. The in-hospital mortality rate was 25% and the morbidity rate was 50%; the two patients that registered complications also needed reinterventions. The patients who were discharged had a good long-term survival. (4) Conclusion: EPD is a challenging procedure, rare encountered in non-traumatic cases, that can be a life-saving intervention in well-selected cases, offering good long-term survival.

摘要

(1) 背景:急诊胰十二指肠切除术(EPD)是一种罕见的手术,尤其是在非创伤中心。胰十二指肠切除术是一项具有挑战性的干预措施,在急诊情况下风险更高。然而,在特定病例中,EPD可能是挽救生命的手术。(2) 方法:我们的研究是一项单中心前瞻性连续病例系列研究,对象为2014年1月至2021年5月在我们外科接受急诊胰十二指肠切除术的患者。(3) 结果:在这7年期间,在615例行胰十二指肠切除术(PD)的患者中,有4例在急诊情况下接受了手术(0.65%)。所有患者均为男性,年龄在44岁至65岁之间。3例因无法控制的出血而进行手术,另1例因复杂的术后并发症而进行手术。3例患者接受了经典的Whipple手术,只有1例进行了保留幽门的胰十二指肠切除术。住院死亡率为25%,发病率为50%;发生并发症的2例患者还需要再次干预。出院的患者长期生存良好。(4) 结论:EPD是一项具有挑战性的手术,在非创伤性病例中很少见,但在精心挑选的病例中可能是挽救生命的干预措施,可提供良好的长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083a/9143146/a571f7de752b/jcm-11-02891-g001.jpg

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