Prediction of Pancreatic Fistula by Preoperatively Assessable Factors; Retrospective Review of Unified Operations by Single Surgeon.
Prediction of Pancreatic Fistula by Preoperatively Assessable Factors; Retrospective Review of Unified Operations by Single Surgeon.
复制标题
通过术前可评估因素预测胰瘘；
DOI：
10.21037/hbsn.2015.12.08
复制
发表时间：
2014
影响因子：
--
通讯作者：
Masao Tanaka
中科院分区：
文献类型：
--
作者：
Masafumi Nakamura;Koji Shindo;Noboru Ideno;J. Ueda;S. Takahata;H. Nakashima;T. Ohtsuka;S. Shimizu;Y. Oda;Masao Tanaka
背景/目标
本研究旨在探讨腹腔镜行远端胰腺切除术(LDP)患者术后胰瘘(POPF)的危险因素。
方法论
52名患者接受了LDP，其中42名患者接受了PFC使用吻合器进行胰腺分割。对术前评估因素与临床POPF发生率的关系进行统计学分析。
结果
42例患者的POPF总发生率为7.1%。单因素分析显示，较大的体重指数(p=0.004)和较厚的胰腺残端(0.0022)是POPF的显著危险因素。多变量分析显示，体重指数和残肢厚度仍然显著(P<；0.0001，P<；0.0001)。ROC曲线估计的截断点为BMI为27 kg/m2，残根厚度为27 mm。
结论
高BMI值和胰腺残端肥厚是LDP术后POPF的重要危险因素。胰腺残端的替代治疗可能会预防高危患者的POPF。
BACKGROUND/AIMS
This retrospective study was conducted to find preoperatively assessable risk factors for postoperative pancreatic fistula (POPF) in patients undergoing laparoscopic distal pancreatectomy (LDP) using a slow compression method with a stapler, which we call pen-firing compression (PFC).
METHODOLOGY
Fifty-two patients underwent LDP, of whom 42 underwent PFC for pancreatic division using a stapler. The relationship between preoperatively assessable factors and the incidence of clinical POPF was statistically analyzed.
RESULTS
Overall rate of POPF was 7.1% in 42 patients. Univariate analysis showed that greater BMI (p = 0.004) and thicker pancreatic stump (0.0022) were significant risk factors for POPF. BMI and stump thickness remained significant (P < 0.0001, P < 0.0001) by multivariate analysis. Cutoff points estimated by ROC curve were 27 kg/m2 for BMI and 27 mm for stump thickness.
CONCLUSIONS
High BMI value and thick pancreatic stump are significant risk factors for POPF after LDP. Alternative treatment of the pancreatic stump may prevent POPF in high-risk patients.