The 1-year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping
The 1-year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping
复制标题
使用垂直与水平床垫缝合进行胃包裹的胰胃造口术后的 1 年结果
DOI：
10.1007/s00595-020-02134-z
复制
发表时间：
2020
期刊：
影响因子：
2.5
通讯作者：
Natsugoe S.
中科院分区：
文献类型：
--
作者：
Maemura K;Mataki Y;Kurahara H;Tanoue K;Kawasaki Y;Ijichi T;Iino S;Ueno S;Shinchi H;Natsugoe S.
目的探讨胰管切除术（PD）患者行胰胃吻合术（PG）后1年营养状况的差异。我们评估了手术和术后因素，营养参数，残余主胰管的直径，和葡萄糖不耐受1年postoperatives.Results45（87%）从VS组和75（91%）从HMS组的患者存活超过1年。HMS组腹腔脓肿和胰瘘的发生率明显低于VS组（分别为19.2% vs.6.6%和19.2% vs.2.6%）。术后1年，总蛋白、血清白蛋白和HbA1c水平无显著变化。HMS组主胰管直径的术后扩张率明显小于VS组。术后1年体重下降的最大危险因素是胰腺质地不软。结论HMS在预防术后早期并发症方面上级优于VS，且不影响胰腺功能。
PurposeTo investigate the differences in nutritional status 1 year after pancreaticogastrostomy (PG) using vertical suturing (VS) vs. twin square horizontal mattress (HMS) suturing in patients undergoing pancreaticoduodenectomy (PD).MethodsThe subjects of this study were 134 patients who underwent PD, followed by PG, which was closed by VS in 52 and by HMS in 82. We evaluated the peri- and postoperative factors, nutritional parameters, diameter of the remnant main pancreatic duct, and glucose intolerance 1 year postoperatively.ResultsForty-five (87%) patients from the VS group and 75 (91%) patients from the HMS group survived for more than 1 year. The incidences of intraabdominal abscess and pancreatic fistula were significantly lower in the HMS group than in the VS group (19.2% vs. 6.6% and19.2% vs. 2.6%, respectively). There were no significant changes in the total protein, serum albumin, and HbA1c levels 1 year postoperatively. The postoperative expansion ratio of the main pancreatic duct diameter was significantly smaller in the HMS group than in the VS group. The strongest risk factor for body weight loss 1 year postoperatively was a non-soft pancreas texture.ConclusionHMS was superior to VS for preventing early postoperative complications and did not affect pancreatic function.