Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates.
Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates.
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DOI：
10.1007/s11605-008-0636-2
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发表时间：
2008-10
影响因子：
3.2
通讯作者：
Fernandez-del Castillo, Carlos
中科院分区：
文献类型：
--
作者：
Ferrone, Cristina R.;Warshaw, Andrew L.;Rattner, David W.;Berger, David;Zheng, Hui;Rawal, Bhupendra;Rodriguez, Ruben;Thayer, Sarah P.;Fernandez-del Castillo, Carlos
胰瘘是远端胰腺切除术（DP）后发病的一个主要来源。我们对 462 名连续接受 DP 的患者进行了回顾，以确定残端闭合方法是否影响瘘管发生率。对 1994 年 2 月至 2008 年 2 月期间接受 DP 的患者的临床病理学变量进行了回顾性审查。采用国际研究组对胰瘘的分类（Bassi 等人，Surgery，138(1):8-13, 2005）。总体胰瘘发生率为29%（133/462）。 321 名 (69%) 患者进行了 DP 联合脾切除术。 116 名 (25%) 患者的其他器官被切除。 227 例患者用鱼口缝合法封闭了胰腺残端，其中 67 例（30%）出现了瘘管。胰管结扎并没有降低瘘管发生率（29% vs. 30%）。 108例患者使用游离镰状补片，瘘管发生率为28%（30/108）。与用钉线加固吻合相比，吻合器的瘘管发生率分别为 24% (10/41) 和 33% (15/45)。不同残端闭合方式之间的瘘管形成率没有显着差异（p=0.73）。多变量分析显示，BMI>30 kg/m2、男性和额外手术是胰瘘的显着预测因素。胰瘘发生率为29%。具有或不具有缝合线加固的缝合器不会显着降低 DP 后的瘘管发生率。减少 DP 后胰瘘仍然是一个尚未解决的挑战。
Pancreatic fistula is a major source of morbidity after distal pancreatectomy (DP). We reviewed 462 consecutive patients undergoing DP to determine if the method of stump closure impacted fistula rates. A retrospective review of clinicopatologic variables of patients who underwent DP between February 1994 and February 2008 was performed. The International Study Group classification for pancreatic fistula was utilized (Bassi et al., Surgery, 138(1):8–13, 2005). The overall pancreatic fistula rate was 29% (133/462). DP with splenectomy was performed in 321 (69%) patients. Additional organs were resected in 116 (25%) patients. The pancreatic stump was closed with a fish-mouth suture closure in 227, of whom 67 (30%) developed a fistula. Pancreatic duct ligation did not decrease the fistula rate (29% vs. 30%). A free falciform patch was used in 108 patients, with a fistula rate of 28% (30/108). Stapled compared to stapled with staple line reinforcement had a fistula rate of 24% (10/41) vs. 33% (15/45). There is no significant difference in the rate of fistula formation between the different stump closures (p=0.73). On multivariate analysis, BMI>30 kg/m2, male gender, and an additional procedure were significant predictors of pancreatic fistula. The pancreatic fistula rate was 29%. Staplers with or without staple line reinforcement do not significantly reduce fistula rates after DP. Reduction of pancreatic fistulas after DP remains an unsolved challenge.
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影响因子：
--
作者：
Rodríguez, JR;Germes, SS;Fernández-del Castillo, CFD
通讯作者：
Fernández-del Castillo, CFD
DOI：
10.1016/j.jamcollsurg.2007.02.077
发表时间：
2007-07-01
影响因子：
5.2
作者：
Sierzega, Marek;Niekowal, Bogdan;Popiela, Tadeusz
通讯作者：
Popiela, Tadeusz
影响因子：
--
作者：
Pannegeon, Virginie;Pessaux, Patrick;Belghiti, Jacques
通讯作者：
Belghiti, Jacques
影响因子：
3.8
作者：
Bassi, C;Dervenis, C;Buchler, M
通讯作者：
Buchler, M
影响因子：
3
作者：
Fahy, BN;Frey, CF;Bold, RJ
通讯作者：
Bold, RJ