Department of HBP and Transplant Surgery, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain.
Gene Therapy and Cancer, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.
Curr Oncol. 2023 Jul 25;30(8):7089-7098. doi: 10.3390/curroncol30080514.
(1) Background: Incisional hernia (IH) is one of the most common complications following open abdominal surgery. There is scarce evidence on its real incidence following pancreatic surgery. The purpose of this study is to evaluate the incidence and the risk factors associated with IH development in patients undergoing pancreaticoduodenectomy (PD). (2) Methods: We retrospectively reviewed all patients undergoing PD between 2014 and 2020 at our centre. Data were extracted from a prospectively held database, including perioperative and long-term factors. We performed univariate and multivariate analysis to detect those factors potentially associated with IH development. (3) Results: The incidence of IH was 8.8% (19/213 patients). Median age was 67 (33-85) years. BMI was 24.9 (14-41) and 184 patients (86.4%) underwent PD for malignant disease. Median follow-up was 23 (6-111) months. Median time to IH development was 31 (13-89) months. Six (31.5%) patients required surgical repair. Following univariate and multivariate analysis, preoperative hypoalbuminemia (OR 3.4, 95% CI 1.24-9.16, = 0.01) and BMI ≥ 30 kg/m (OR 2.6, 95% CI 1.06-8.14, = 0.049) were the only factors independently associated with the development of IH. (4) Conclusions: The incidence of IH following PD was 8.8% in a tertiary care center. Preoperative hypoalbuminemia and obesity are independently associated with IH occurrence following PD.
(1) 背景：切口疝（IH）是开放性腹部手术后最常见的并发症之一。关于胰腺手术后 IH 的实际发生率，证据很少。本研究旨在评估胰十二指肠切除术（PD）后 IH 发展的发生率和相关风险因素。(2) 方法：我们回顾性分析了 2014 年至 2020 年在我们中心接受 PD 的所有患者。数据从一个前瞻性保存的数据库中提取，包括围手术期和长期因素。我们进行了单因素和多因素分析，以检测与 IH 发展相关的潜在因素。(3) 结果：IH 的发生率为 8.8%（213 例患者中有 19 例）。中位年龄为 67（33-85）岁。BMI 为 24.9（14-41），184 例（86.4%）患者因恶性疾病接受 PD。中位随访时间为 23（6-111）个月。IH 发展的中位时间为 31（13-89）个月。6 例（31.5%）患者需要手术修复。单因素和多因素分析后，术前低白蛋白血症（OR 3.4，95%CI 1.24-9.16， = 0.01）和 BMI≥30kg/m（OR 2.6，95%CI 1.06-8.14， = 0.049）是 IH 发展的唯一独立相关因素。(4) 结论：在一家三级保健中心，PD 后 IH 的发生率为 8.8%。术前低白蛋白血症和肥胖是 PD 后 IH 发生的独立相关因素。
