摘要
目的:分析腹腔镜胰十二指肠切除术(laparoscopic pancreaticoduodenectomy,LPD)后胰漏发生的危险因素。方法:回顾性分析2013年11月至2016年9月,我院所行LPD的128例病人临床资料。分为胰漏组和非胰漏组,对可能导致术后胰漏发生的相关因素以及并发症发生和病死率进行分析。结果:128例病人中36例(28.13%)发生术后胰漏。非胰漏组92例。胰漏组年龄、性别、术前白蛋白、术前总胆红素、手术时间与非胰漏组不存在差异。体质量指数(BMI)、术中出血量、胰肠吻合方式与胰漏发生相关(P<0.05)。只有BMI是胰漏发生的独立危险因素(P=0.029),BMI>25时,术后易发生胰漏。胰漏组术后出血、腹腔感染、2次手术率明显增多,而非胰漏组术后住院时间和ICU时间较短(P<0.001)。两组病人术后胆漏、胃排空障碍、病死率之间无统计学差异。结论:BMI是LPD胰漏发生的独立危险因素。
Objective To analyze the risk factor of pancreatic fistula after laparoscopic pancreaticoduodenectomy. Methods The clinical data of 128 cases with laparoseopie panereaticoduodenectomy performed from November 2013 to September 2016 in our hospital were retrospectively analyzed. The patients were divided into pancreatic fistula group and control group without fistula. The risk factor of pancreatic fistula and the mobidity with mortality were analyzed. Results Pancreatic fistula developed in 36（28.13%） patients after surgery. Ninty-two cases were in control group. There was no dif- ference of the factors including age, gender, preoperative albumin and total bilirubin, and operation time between pancreat- ic fistula group and control group. Body mass index （BMI）, intraoperative blood loss and the mode of pancreatic anastomo- sis in pancreatic fistula group was different from those in control group （P〈0.05）. Only BMI was an independent risk factor for pancreatic fistula （P=0.029） when BMI more than 25. The cases with postoperative bleeding, abdominal infection and reoperation were more in pancreatic fistula group than in control group （P〈0.05）. The postoperative hospital stay and ICU stay was less in control group than that in pancreatic fistula group （P〈0.05）. No statistical difference was found in biliary fistula, gastric emptying disorder and mortality between two groups. Conclusions BMI is an independent risk factor for pancreatic fistula after laparoscopic pancreaticoduodenectomy.
出处
《外科理论与实践》
2017年第2期129-133,共5页
Journal of Surgery Concepts & Practice
关键词
腹腔镜
胰十二指肠切除术
胰漏
术后并发症
Laparoscopy
Pancreaticoduodenectomy
Pancratic fistula
Postoperation complication
