| Autor: |
Yin TY; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Wang XX; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Zhang H; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Guo XJ; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Wang M; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Qin RY; Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China. |
| Jazyk: |
čínština |
| Zdroj: |
Zhonghua wai ke za zhi [Chinese journal of surgery] [Zhonghua Wai Ke Za Zhi] 2024 Jul 01; Vol. 62 (7), pp. 671-676. |
| DOI: |
10.3760/cma.j.cn112139-20240317-00130 |
| Abstrakt: |
Objective: To compare the perioperative outcomes of laparoscopic duodenal-preserving pancreatic head resection(LDPPHR) with laparoscopic pancreaticoduodenectomy(LPD) in the treatment of borderline and benign diseases of the pancreatic head. Methods: This is a retrospective cohort study. Perioperative data from 87 patients with non-malignant pancreatic head diseases who underwent LDPPHR or LPD were retrospectively collected in the Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2022. There were 49 male and 38 female patients with an age ( M (IQR)) of 57.0(16.5) years (range: 20 to 75 years). Forty patients underwent LDPPHR and 47 patients underwent LPD. Quantitative data following a normal distribution were compared using Student's t -test, while quantitative data not following a normal distribution were compared using the Mann-Whitney U test. Comparisons of categorical or ordinal variables were made using χ 2 test or Fisher's exact test. Logistic regression analysis was used to estimate the risk factors associated with the rate of complications. Results: There were no statistically significant differences between the LDPPHR group and the LPD group in terms of reoperation rate,total hospital stay duration,postoperative hospital stay duration,90-day mortality rate,30-day and 90-day readmission rates,and 2-year tumor recurrence rate (all P >0.05). The complication rate was higher in the LDPPHR group compared to the LPD group (80.0%(32/40) vs. 51.1%(24/47), χ 2 =7.89, P =0.005),but there was no difference in the rate of Clavien-Dindo classification of surgical complications ≥Ⅲ between the two groups (10.0%(4/40) vs. 12.8%(6/47), χ 2 <0.01, P =0.947). Additionally,the rate of delayed gastric emptying (DGE) was higher in the LDPPHR group compared to the LPD group ( χ 2 =10.79, P =0.001),but there was no statistically significant difference in the rate of B,C grade DGE between the two groups ( χ 2 =0.48, P =0.487). There were no statistically significant differences in the rates of postoperative pancreatic fistula,bile leakage,post-pancreatectomy hemorrhage,intra-abdominal infection,and pulmonary infection between the two groups (all P >0.05). The results of the univariate logistic regression analysis showed that LDPPHR (compared to LPD, OR =3.83, 95% CI : 1.46 to 10.04, Z =2.73, P =0.006) and preoperative biliary stent placement (compared to non-use of biliary stent, OR =5.30, 95% CI : 1.13 to 25.00, Z =2.11, P =0.035) were risk factors for the complication rate,but neither was an independent risk factor for complication rate (all P >0.05). Conclusion: The preliminary results suggest that LDPPHR can achieve perioperative safety and effectiveness comparable to LPD. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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