Preoperative cholangitis during biliary drainage increases the incidence of postoperative severe complications after pancreaticoduodenectomy
Preoperative cholangitis during biliary drainage increases the incidence of postoperative severe complications after pancreaticoduodenectomy
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DOI：
10.1016/j.amjsurg.2013.10.021
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发表时间：
2014-07-01
影响因子：
3
通讯作者：
Yamaue, Hiroki
中科院分区：
文献类型：
--
作者：
Kitahata, Yuji;Kawai, Manabu;Yamaue, Hiroki
背景：术前胆道引流对胰腺十二指肠切除术(PD)后严重并发症的影响仍存在争议。方法：回顾分析127例患者，其中60例外引流，67例内引流。结果：内引流组术前胆管炎发生率(22.4%)明显高于外引流组(1.7%)。有胆管炎的患者严重并发症(III级或以上)的发生率(62.5%)显著高于无胆管炎的患者(25.2%；P=0.002)。胆管炎患者胃排空延迟的发生率(31.2%)显著高于无胆管炎患者(5.4%；P=.001)。多因素Logistic回归分析显示，术前胆管炎(优势比4.61，95%可信区间1.3~16.5；P=0.019)是PD术后严重并发症的独立危险因素。结论：术前胆道引流期间胆管炎显著增加PD术后严重并发症的发生率。(C)2014 Elsevier Inc.保留所有权利。
BACKGROUND: It remains controversial how preoperative biliary drainage affects occurrence of severe complications after pancreaticoduodenectomy (PD).METHODS: One hundred twenty-seven patients (60 external drainage and 67 internal drainage) required biliary drainage before PD were retrospectively reviewed.RESULTS: Preoperative cholangitis in internal drainage group (22.4%) occurred significantly more often than in external drainage group (1.7%; P < .001). The incidence of severe complications (grade III or more) was significantly higher in patients with cholangitis (62.5%) than in those without it (25.2%; P = .002). The incidence of delayed gastric emptying was significantly higher in patients with cholangitis (31.2%) than in those without it (5.4%; P = .001). A multivariate logistic regression analysis revealed that preoperative cholangitis (odds ratio 4.61, 95% confidence interval 1.3 to 16.5; P = .019) was the independent risk factor for severe complications after PD.CONCLUSIONS: Preoperative cholangitis during biliary drainage significantly increases incidence of severe complications after PD. (C) 2014 Elsevier Inc. All rights reserved.