胰十二指肠切除术后胰瘘相关因素的Meta分析  

RISK FACTORS FOR PANCREATIC FISTULA AFTER PANCREATICODUODENECTOMY:A META-ANALYSIS

作　　者：李滔[1] 依马木买买提江.阿布拉 易超[1] 李海军[2] 

机构地区：[1]新疆医科大学附属肿瘤医院肝胆外科,新疆乌鲁木齐830000 [2]深圳市罗湖区人民医院外科中心

出　　处：《齐鲁医学杂志》2015年第4期419-422,共4页Medical Journal of Qilu

基　　金：新疆维吾尔自治区科技支疆项目(201291170)

摘　　要：目的探讨胰十二指肠切除术后发生胰瘘的危险因素。方法采用根据PRISMA声明制定的Meta分析法,检索2009年1月—2013年12月公开发表的关于胰十二指肠切除术后发生胰瘘相关因素的文献,应用RevMan 5.2软件进行数据的提取和分析。结果共有14篇文献纳入研究。胰十二指肠切除术中胰胃吻合与胰肠吻合术后胰瘘发生率相当（P〉0.05）;有无糖尿病与胰瘘的发生无明显相关性（P〉0.05）。体质量指数（BMI）≥25kg/m2病人术后胰瘘发生率明显增高（OR=3.52,95%CI=2.31~5.36,P〈0.05）;主胰管直径≥3 mm病人胰瘘发生率明显小于直径〈3mm病人（OR=0.24,95%CI=0.17~0.35,P〈0.05）;胰腺质软病人的胰瘘发生率明显高于质硬病人（OR=6.03,95%CI=3.72~9.77,P〈0.05）;术后病理诊断为胰腺癌病人的胰瘘发生率明显低于非胰腺癌病人（OR=0.32,95%CI=0.24~0.44,P〈0.05）。结论 BMI、胰管直径、胰腺质地、是否胰腺癌为胰十二指肠切除术后发生胰瘘的危险因素。Objective To explore the risk factors of pancreatic fistula（PF）after pancreaticoduodenectomy（PD）.Methods Using the Meta analytical method established by PRISMA statement,literature on postoperative pancreatic fistula（PF）after PD published during January 2009 and December 2013 was searched,the data were fetched and analyzed employing RevMan5.2software. Results A total of 14 documents were collected in this study.The incidence rate of PF after pancreaticogastrostomy（PG）and pancreaticojejunostomy（PJ）was about the same（P 〉0.05）,and there was no significant correlation between whether or not with diabetes and complications（P〉0.05）.The incidence of postoperative PF was obviously high in patients with BMI of≥25kg/m2（OR=3.52,95%CI=2.31-5.36,P〈0.05）.In those with main pancreatic duct（MPD）of≥3mm,the incidence of postoperative PF was lower than that of〈3mm in diameter（OR=0.24,95%CI=0.17-0.35,P〈0.05）.The incidence of PF in those with soft pancreatic texture was obviously higher than the hard texture ones（OR=6.03,95%CI=3.72-9.77,P〈0.05）.The incidence of PF in patients with pancreatic cancer confirmed by postoperative pathology was much lower than that in non-pancreatic-cancer patients（OR=0.32,95%CI=0.24-0.44,P〈0.05）. Conclusion The risk factors for pancreatic fistula after pancreaticoduodenectomy are：BMI of the patient,diameter of pancreatic duct,texture of pancreas,and whether or not it is cancer.

关 键 词：胰十二指肠切除术 胰腺瘘 危险因素 META分析 

分 类 号：R657.5[医药卫生—外科学]