摘要
目的:探讨外部支架引流对减少胰十二指肠切除术(PD)后采用胰肠套入吻合术患者术后胰瘘(POPF)的临床价值及POPF的影响因素。方法:将97例PD后行胰肠套入吻合术患者,随机分为支架组(49例)和非支架组(48例),其中支架组胰管扩张26例,非支架组胰管扩张24例。比较两组患者POPF发生率并分析POPF的影响因素。结果:与非支架组比较,支架组POPF发生率明显降低(6.12%vs.22.9%)(P<0.05);在胰管扩张患者中,两组的POPF发生率无统计学差异(3.8%vs.8.3%)(P>0.05);而在非胰管扩张患者中,支架组POPF发生率明显低于非支架组(8.7%vs.37.5%)(P<0.05)。多因素分析结果显示患者的体质量指数(BMI)、胰管尺寸、支架有无是POPF的独立危险因素(OR=11.37;9.17;6.73,均P<0.05)。结论:胰管支架引流可以减少PD后胰肠套入吻合术患者POPF的发生,POPF的发生还与患者BMI,胰管尺寸有关。
Objective： To investigate the clinical value of external stent drainage for reducing postoperative pancreatic fistula （POPF） in patients undergoing invagination pancreaticojejunostomy（PJ） after pancreaticoduodenectomy（PD） and the influential factors for POPF.Methods： Ninety-seven patients undergoing invagination PJ procedure following PD were randomly designated to stenting group （49 cases）and non-stenting group （48 cases）. Of the patients, 26 cases in stenting group and 24 cases in non-stenting group presented with pancreatic duct dilatation. Xhe occurrences of POPF between the two groups of patients were compared, and the influential factors for POPF were determined. Results： Compared with non-stenting group, the incidence of POPF in stenting group was significantly reduced （6.12% vs. 22.9%） （P〈0.05）. The incidence of POPF showed no significant difference between the two groups among the patients with pancreatic duct dilatation （3.8% vs. 8.3%） （V〉0.05）, while it was was significantly lower in stenting group than that in non-stenting group among the patients without pancreatic duct di｜atation （8.7% vs. 37.5%） （P〈0.05）. Multivariate analysis indicated that the body mass index （BMI）, size of the pancreatic duct, and whether there was stenting or not were independent risk factors for POPF （OR=11.37; 9.17; 6.73, all P〈0.05）. Conclusion： The external stent drainage can reduce the incidence of POPF in patients undergoing invagination PJ after PD, and POPF is also associated with the BMI and size of the pancreatic duct of the patients.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2013年第9期1185-1189,共5页
China Journal of General Surgery
