Department of Surgery, Barnes-Jewish Hospital and the Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
Department of Surgery, Barnes-Jewish Hospital and the Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
HPB (Oxford). 2023 Jun;25(6):659-666. doi: 10.1016/j.hpb.2023.02.015. Epub 2023 Feb 24.
Proton pump inhibitors (PPIs) are effective in reducing marginal ulcers after pancreatoduodenectomy. However, their impact on perioperative complications has not been defined.
We retrospectively analyzed the effect of postoperative PPIs on 90-day perioperative outcomes in all patients who underwent pancreatoduodenectomy at our institution from April 2017 to December 2020.
284 patients were included; 206 (72.5%) received perioperative PPIs, 78 (27.5%) did not. The two cohorts were similar in demographics and operative variables. Postoperatively, the PPI cohort had significantly higher rates of overall complications (74.3% vs. 53.8%) and delayed gastric emptying (28.6% vs. 11.5%), p < 0.05. However, no differences in infectious complications, postoperative pancreatic fistula, or anastomotic leaks were seen. On multivariate analysis, PPI was independently associated with a higher risk of overall complications (OR 2.46, CI 1.33-4.54) and delayed gastric emptying (OR 2.73, CI 1.26-5.91), p = 0.011. Four patients developed marginal ulcers within 90-days postoperatively; all were in the group who received PPIs.
Postoperative proton pump inhibitor use was associated with a significantly higher rate of overall complications and delayed gastric emptying after pancreatoduodenectomy.
质子泵抑制剂（PPIs）可有效减少胰十二指肠切除术后边缘性溃疡。然而，其对围手术期并发症的影响尚未确定。
我们回顾性分析了我院 2017 年 4 月至 2020 年 12 月期间所有接受胰十二指肠切除术患者术后使用质子泵抑制剂对 90 天围手术期结局的影响。
共纳入 284 例患者；206 例（72.5%）接受围手术期质子泵抑制剂治疗，78 例（27.5%）未接受治疗。两组患者在人口统计学和手术变量方面无差异。术后，质子泵抑制剂组总体并发症发生率（74.3% vs. 53.8%）和胃排空延迟（28.6% vs. 11.5%）明显更高，p<0.05。但两组间感染性并发症、术后胰瘘或吻合口漏无差异。多因素分析显示，质子泵抑制剂与总体并发症（OR 2.46，CI 1.33-4.54）和胃排空延迟（OR 2.73，CI 1.26-5.91）的风险增加独立相关，p=0.011。术后 90 天内有 4 例发生边缘性溃疡，均在使用质子泵抑制剂组。
胰十二指肠切除术后使用质子泵抑制剂与总体并发症和胃排空延迟的发生率显著增加相关。
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