Postoperative Bowel Function and Nutritional Status following Distal Pancreatectomy with En-Bloc Celiac Axis Resection
Postoperative Bowel Function and Nutritional Status following Distal Pancreatectomy with En-Bloc Celiac Axis Resection
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DOI：
10.1159/000265573
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发表时间：
2010-01-01
影响因子：
2.7
通讯作者：
Matsumoto, Joe
中科院分区：
文献类型：
--
作者：
Hirano, Satoshi;Kondo, Satoshi;Matsumoto, Joe
背景/目的：远端胰腺切除术联合腹腔轴整块切除术（DP-CAR）通常伴有双侧腹腔神经节和肠系膜上动脉环丛的完全切除。术后情况，包括排便、营养状况和对辅助化疗的耐受性从未被研究过。方法：40 例接受 DP-CAR 治疗的患者纳入本研究。通过抗腹泻药物的需求来评估术后肠功能。评估术后1年的体重和实验室数据等营养参数的变化。结果：中位随访期 39 个月后，15 名患者 (38%) 不再需要使用止泻药。其他患者服用止泻药物后排便得到良好控制。尽管 7 名接受吉西他滨的患者出现血液学毒性，但 13 名接受辅助化疗的患者耐受性良好。术后体重明显下降，并在术后第3个月达到平台值。表明营养状况的实验室数据在术后1个月显着降低，并在3至12个月内恢复。结论：接受DP-CAR的患者很少出现顽固性腹泻，术后能够达到可行的营养状态，能够接受辅助化疗。版权所有 (C) 2010 S. Karger AG，巴塞尔
Background/Aims: Distal pancreatectomy with en-bloc celiac axis resection (DP-CAR) is routinely accompanied by complete resection of the bilateral celiac ganglions and the circumferential plexus of the superior mesenteric artery. The postoperative condition including bowel movement, nutritional status, and tolerance to adjuvant chemotherapy has never been studied. Methods: 40 patients who underwent DP-CAR were enrolled in this study. Postoperative bowel function was estimated by the requirement of anti-diarrheal agents. Changes of nutritional parameters including body weight and laboratory data for 1 year after surgery were evaluated. Results: 15 (38%) patients needed no anti-diarrheal agent after a median follow-up period of 39 months. The other patients were well controlled for their bowel movement with anti-diarrheal drugs. 13 patients who received adjuvant chemotherapy tolerated it well despite hematologic toxicity in 7 patients who received gemcitabine. Postoperative body weight was significantly decreased and reached a plateau value at postoperative month 3. The values of laboratory data indicating nutritional status were significantly lower at 1 month after surgery and recovered between 3 and 12 months. Conclusion: The patients who underwent DP-CAR scarcely suffered from intractable diarrhea and could achieve a feasible nutritional status after surgery to be able to receive adjuvant chemotherapy. Copyright (C) 2010 S. Karger AG, Basel