胰十二指肠切除术后胃排空延迟的危险因素研究
Study of risk factors for delayed gastric emptying after partial pancretoduodenectomy.
作者信息
Martín S, Secanella Ll, Sorribas M, Peláez N, Salord S, Lopez-Urdiales R, Fabregat J, Busquets J
机构信息
General and Digestive Surgery Service, Viladecans Hospital, Viladecans, Spain.
Department of Hepatobiliary and Pancreatic Surgery, Bellvitge University Hospital, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, University of Barcelona L'Hospitalet de Llobregat, Barcelona, Spain.
出版信息
Cir Esp (Engl Ed). 2023 Oct;101(10):657-664. doi: 10.1016/j.cireng.2023.01.003. Epub 2023 Jan 27.
INTRODUCTION
Delayed gastric emptying is one of the most frequent complications after pancreatoduodenectomy.
METHODS
We performed an analysis of risk factors for delayed gastric emptying on a prospective database of 390 patients operated on between 2013 and 2021. A comparative retrospective study was carried out between patients with and without delayed gastric emptying and subsequently a study of risk factors for delayed gastric emptying using univariate and multivariate logistic regression models.
RESULTS
The incidence of delayed gastric emptying in the overall series was 28%. The morbidity of the group was 63%, and postoperative mortality was 3.1%. Focusing on delayed gastric emptying, the median age (73 years vs 68 years, P < 0.001) and preoperative creatinine (75 vs 65.5, P < 0.001) were higher in the group with this complication. The study of risk factors showed that age over 60 years (P = 0.002) and pancreatic fistula (P < 0.001) were risk factors for delayed gastric emptying.
CONCLUSION
The presence of pancreatic fistula is confirmed as a risk factor for slow gastric emptying after pancreaticoduodenectomy. In addition, age over 60 years is shown to be a risk factor for slow gastric emptying.
引言
胃排空延迟是胰十二指肠切除术后最常见的并发症之一。
方法
我们对2013年至2021年间接受手术的390例患者的前瞻性数据库进行了胃排空延迟危险因素分析。对有和没有胃排空延迟的患者进行了一项比较性回顾性研究，随后使用单变量和多变量逻辑回归模型对胃排空延迟的危险因素进行了研究。
结果
整个系列中胃排空延迟的发生率为28%。该组的发病率为63%，术后死亡率为3.1%。聚焦于胃排空延迟，出现该并发症的组中位年龄（73岁对68岁，P < 0.001）和术前肌酐水平（75对65.5，P < 0.001）更高。危险因素研究表明，60岁以上（P = 0.002）和胰瘘（P < 0.001）是胃排空延迟 的危险因素。
结论
胰瘘的存在被确认为胰十二指肠切除术后胃排空缓慢的一个危险因素。此外，60岁以上被证明是胃排空缓慢的一个危险因素。
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