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改良Blumgart吻合术对腹腔镜胰十二指肠切除术中胰瘘和胰肠吻合时间的影响:单中心经验

Impact of Modified Blumgart Anastomosis on Pancreatic Fistula and Pancreaticojejunostomy Time During Laparoscopic Pancreaticoduodenectomy: Single-Center Experience.

作者信息

Lee Jong Woo, Kwon Jae Hyun, Lee Jung-Woo

机构信息

Department of Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.

出版信息

J Clin Med. 2024 Dec 27;14(1):90. doi: 10.3390/jcm14010090.

DOI:10.3390/jcm14010090
PMID:39797173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11722071/
Abstract

/: The aim of this study is to evaluate the impact of modified Blumgart anastomosis methods during pancreaticojejunostomy (PJ) on the incidence of clinically relevant postoperative pancreatic fistula (POPF) after laparoscopic pancreaticoduodenectomy (LPD). : This is a retrospective cohort study analyzing data of patients who underwent LPD from 2018 to 2022. The primary endpoint was the incidence of grade B and C POPF based on the International Study Group on Pancreatic Fistula criteria and PJ anastomosis time. Incidence of postoperative complications (Clavien-Dindo classification grade ≥ III) was also investigated. : A total of 148 patients, 99 patients in a modified Blumgart group and 49 patients in a continuous suture group, were enrolled. There were no statistically significant differences in the general and intraoperative characteristics found between the two groups ( > 0.05). There was no significant difference in pancreas texture ( = 0.397) and diameter of pancreatic duct ( = 0.845). Grade B and C POPF occurred in five patients (5.1%) in the modified Blumgart group and three patients (6.1%) in the continuous suture group with no statistical difference ( = 0.781). A total of eleven patients (11.1%) in the modified Blumgart group and four patients (8.2%) in the continuous suture group had postoperative complication (Clavien-Dindo Classification grade 3 or more). Mortality within 90 days was 2 (2%) and 0 (0%), respectively. The PJ anastomosis times in the modified Blumgart group and continuous suture group were 28.8 ± 5.94 min and 35 ± 7.71 min, respectively ( = 0.003). : This study suggests that modified Blumgart PJ showed shorter anastomosis time with comparable outcome to continuous suture methods in LPD.

摘要

目的

本研究旨在评估胰十二指肠吻合术(PJ)中改良 Blumgart 吻合方法对腹腔镜胰十二指肠切除术(LPD)后临床相关术后胰瘘(POPF)发生率的影响。

方法

这是一项回顾性队列研究,分析了 2018 年至 2022 年接受 LPD 患者的数据。主要终点是根据国际胰瘘研究组标准和 PJ 吻合时间的 B 级和 C 级 POPF 发生率。还调查了术后并发症(Clavien-Dindo 分类≥III 级)的发生率。

结果

共纳入 148 例患者,改良 Blumgart 组 99 例,连续缝合组 49 例。两组间一般和术中特征无统计学显著差异(P>0.05)。胰腺质地(P = 0.397)和胰管直径(P = 0.845)无显著差异。改良 Blumgart 组 5 例患者(5.1%)发生 B 级和 C 级 POPF,连续缝合组 3 例患者(6.1%)发生,无统计学差异(P = 0.781)。改良 Blumgart 组共 11 例患者(11.1%)、连续缝合组 4 例患者(8.2%)发生术后并发症(Clavien-Dindo 分类 3 级或更高)。90 天内死亡率分别为 2 例(2%)和 0 例(0%)。改良 Blumgart 组和连续缝合组的 PJ 吻合时间分别为 28.8±5.94 分钟和 35±7.71 分钟(P = 0.003)。

结论

本研究表明,改良 Blumgart PJ 在 LPD 中吻合时间更短,与连续缝合方法效果相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/11722071/58e176b94839/jcm-14-00090-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/11722071/e3b44324ba53/jcm-14-00090-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/11722071/58e176b94839/jcm-14-00090-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/11722071/e3b44324ba53/jcm-14-00090-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/11722071/58e176b94839/jcm-14-00090-g002.jpg

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2
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BMC Surg. 2023 Nov 16;23(1):349. doi: 10.1186/s12893-023-02221-1.
3
Association of a Modified Blumgart Anastomosis With the Incidence of Pancreatic Fistula and Operation Time After Laparoscopic Pancreatoduodenectomy: A Cohort Study.
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