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远端胰腺切除术后胃排空延迟的危险因素识别——基于德国StuDoQ|胰腺登记处对1688例患者的评估

Risk Factor Identification for Delayed Gastric Emptying after Distal Pancreatectomy-An Evaluation of 1688 Patients Based on the German StuDoQ|Pancreas Registry.

作者信息

Fahlbusch Tim, Höhn Philipp, Klinger Carsten, Werner Jens, Keck Tobias, Friess Helmut, Köninger Jörg, Kraus Thomas W, Alsfasser Guido, Padberg Winfried, Ritz Jörg-Peter, Uhl Waldemar, Belyaev Orlin

机构信息

Department of General and Visceral Surgery, St. Josef Hospital, Ruhr-University Bochum, 44801 Bochum, Germany.

Deutsche Gesellschaft für Allgemein-und Viszeralchirurgie, 10117 Berlin, Germany.

出版信息

J Clin Med. 2022 Sep 21;11(19):5539. doi: 10.3390/jcm11195539.

Abstract

Delayed gastric emptying (DGE) ranks as one of the most frequent complications in pancreatic surgery. It leads to increased costs for healthcare systems, lengthened hospital stays and reduced quality of life. Data about DGE after distal pancreatectomy (DP) are scarce. The StuDoQ|Pancreas registry of the German Society of General and Visceral Surgery provided data of patients who underwent distal pancreatectomy from 1 January 2014 to 31 December 2018. The retrospective evaluation included comprehensive data: 1688 patients were enrolled; DGE occurred 160 times (9.5%); grade “A” was reported for 98 (61.3%), grade “B” for 41 (25.6%) and grade “C” for 21 (13.1%) patients. In univariate analysis pancreatic fistulas were associated with higher frequencies of intraabdominal abscesses (9.1% vs. 2%, p > 0.001), postpancreatectomy haemorrhage (8.1% vs. 3.7%, >0.001) and DGE (14.5% vs. 6%, p < 0.001). According to multivariate analysis, “abscesses with invasive therapy” (p < 0.001), “other surgical complications” (p < 0.001), prolonged “stays in ICU” (p < 0.001), lengthened duration of surgery (p < 0.001) and conventional surgery (p = 0.007) were identified as independent risk factors for DGE. Perioperative and postoperative factors were identified as risk factors for DGE. Following research should examine this highly relevant topic in a prospective, register-based manner. As there is no causal therapy for DGE, its avoidance is of major importance.

摘要

胃排空延迟(DGE)是胰腺手术中最常见的并发症之一。它会导致医疗系统成本增加、住院时间延长以及生活质量下降。关于远端胰腺切除术(DP)后DGE的数据很少。德国普通和内脏外科学会的StuDoQ|胰腺登记处提供了2014年1月1日至2018年12月31日接受远端胰腺切除术患者的数据。回顾性评估纳入了全面的数据:共纳入1688例患者;发生DGE 160次(9.5%);报告“A”级98例(61.3%),“B”级41例(25.6%),“C”级21例(13.1%)。单因素分析显示,胰瘘与腹腔内脓肿(9.1%对2%,p>0.001)、胰腺切除术后出血(8.1%对3.7%,>0.001)和DGE(14.5%对6%,p<0.001)的发生率较高相关。多因素分析显示,“侵袭性治疗的脓肿”(p<0.001)、“其他手术并发症”(p<0.001)、延长的“ICU住院时间”(p<0.001)、手术时间延长(p<0.001)和传统手术(p=0.007)被确定为DGE的独立危险因素。围手术期和术后因素被确定为DGE的危险因素。后续研究应以基于登记的前瞻性方式研究这一高度相关的主题。由于目前尚无针对DGE的因果治疗方法,避免其发生至关重要。

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