Complications after pancreaticoduodenectomy: the problem of current definitions
Complications after pancreaticoduodenectomy: the problem of current definitions
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DOI：
10.1007/s00534-005-1035-7
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Bassi, Claudio
中科院分区：
文献类型：
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作者：
Butturini, Giovanni;Marcucci, Stefano;Bassi, Claudio
如今，胰腺炎切除术对外科医生来说是一个复杂的过程和挑战。尽管有经验的外科医生报告死亡率低于5%，但发病率仍在30%-50%左右，通常导致住院时间延长，需要进行术后检查和手术，并对并发症患者进行门诊监测。在文献中，对胰腺切除术后并发症的定义没有达成一致，导致不同专科的并发症发生率差异很大，特别是关于每种并发症的来源，术后胰瘘和其他并发症，如胃排空延迟。一些作者已经证明，在同质、单中心系列中应用不同的定义，并发症的发生率具有统计学显著性，这意味着不可能正确比较不同的经验。似乎有必要在外科专家之间组织一次共识会议，以制定世界范围内接受的定义。本文的目的是审查目前有争议的定义，并提出一个新的临床为基础的方法来解决问题的可行性和可靠性的定义本身。
Pancreaticoduodenectomy nowadays represents a complex procedure and a challenge for the surgeon. Even though mortality is reported to be below 5% for experienced surgeons, morbidity is still around 30%-50%, often leading to prolongation of hospital stay, demanding postoperative investigations and procedures, and outpatient monitoring of the patients with complications. In the literature there is no agreement on the definitions of postoperative complications following pancreaticoduodenectomy, leading to a wide range of complication rates in different specialist units, particularly regarding the source of every complication, postoperative pancreatic fistula, and others such as delayed gastric emptying. Some authors have demonstrated that applying different definitions in homogeneous, single-center series, the incidence of a complication varied with statistical significance, implying the impossibility of correctly comparing different experiences. It seems essential to organize a Consensus Meeting among expert surgeons to prepare world-wide accepted definitions. The aim of this article is to review the current controversial definitions and to suggest a new clinical-based approach to the problem of the feasibility and reliability of the definitions themselves.