高龄病人行胰十二指肠切除术探讨  

Discussion of pancreatoduodenectomy in older patients

作　　者：郭德凯 刘蕾 马睿锐 贡海兵 李兵兵 高翔[1] 江雨波 汪洋[1] 王从俊 GUO Dekai;LIU Lei;MA Ruirui(Department of Digestive Surgery,Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201600China)

机构地区：[1]上海交通大学医学院附属松江医院消化外科,201600 [2]上海交通大学医学院附属仁济医院

出　　处：《临床外科杂志》2022年第7期653-656,共4页Journal of Clinical Surgery

摘　　要：目的探讨80岁以上高龄病人行胰十二指肠切除术的可行性。方法2017年3月~2020年10月我院收治胰十二指肠切除术病人58例。高龄组28例,年龄>80岁,非高龄组30例,年龄<80岁。比较两组病人术前合并症、手术相关情况及术后并发症发生率。结果高龄组术前合并高血压13例,心脏病7例,糖尿病9例,低蛋白血症16例,非高龄组分别为7例,4例,3例及7例,两组比较差异有统计学意义(P<0.05)。高龄组手术时间(172.4±33.2)分钟,术中出血量(160.0±84.4)ml,非高龄组分别为(160.6±35.8)分钟、(156.6±84.8)ml,两组比较差异无统计学意义(P>0.05)。高龄组术后住院时间(22.6±9.0)天,非高龄组(18.9±2.8)天,两组比较差异有统计学意义(P<0.05)。两组术后并发胰瘘、胆漏、腹腔感染、胃排空延迟及腹腔出血等比较,差异无统计学意义(P>0.05)。高龄组因严重胰瘘致出血死亡1例,非高龄组无死亡,两组比较差异无统计学意义(P>0.05)。结论高龄病人行胰十二指肠切除手术,需要充分的术前准备、术中精细操作和术后有效管理防治并发症,即使是超过80岁的高龄病人,手术也是安全可行的。Objective To investigate the feasibility of pancreaticoduodenectomy in elderly patients over 80 years old.Methods A retrospective analysis of 58 patients with pancreaticoduodenectomy performed in Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2017 to October 2020.Taking 80 years old as the classification standard,28 people aged 80 and above belong to the senior group,and 30 people aged 80 and below belong to the non-elderly group.The preoperative complications,surgery-related conditions and postoperative complications were compared between the two groups.Results The preoperative comorbidities of the two groups were compared.There were 13 cases of hypertension,7 cases of heart disease,9 cases of diabetes mellitus and 16 cases of hypoalbuminemia in the elderly group,and 7 cases,4 cases,3 cases and 7 cases in the non-senior age group,respectively.The difference was statistically significant(P<0.05).Comparison of operation-related indicators between the two groups,the operation time in the elderly group was(172.4±33.2)minutes,and the intraoperative blood loss was(160.0±84.4)ml,while the non-elderly group was(160.6±35.8)minutes and(156.6±84.8)ml,respectively.There was no significant difference between groups(P>0.05).The postoperative hospital stay days in the elderly group were(22.6±9.0)days and in the non-elderly group(18.9±2.8)days,there was a statistically significant difference between the two groups(P<0.05).The postoperative complications,including pancreatic fistula,bile leakage,intra-abdominal infection,delayed gastric emptying and intra-abdominal hemorrhage,showed no significant difference between the two groups(P>0.05).In the comparison of prognostic indicators,there was 1 case of severe pancreatic fistula-induced hemorrhage death in the elderly group,and no death in the non-elderly group,and the difference was not statistically significant(P>0.05).Conclusion Pancreaticoduodenectomy in elderly patients requires adequate preoperative preparation,meticulous int

关 键 词：胰十二指肠切除术 术前合并症 术后并发症 可行性 

分 类 号：R657.5[医药卫生—外科学]