胰管支撑管不同放置方式对Whipple术后胰瘘的影响  

Effect of different placement of pancreatic duct supporting duct on pancreatic fistula after Whipple

作　　者：王煜东 李晓琦 刘彦琦[2] Wang Yudong;Li Xiaoqi;Liu Yanqi(Department of Hepatobiliary Surgery,Inner Mongolia Medical University Affiliated Hospital,Hohhot 010050,China;Department of Digestive Endoscopy Center,Inner Mongolia Medical University Affiliated Hospital,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院肝胆外科,呼和浩特010050 [2]内蒙古医科大学附属医院消化内镜中心,呼和浩特010050

出　　处：《中华实验外科杂志》2023年第12期2600-2604,共5页Chinese Journal of Experimental Surgery

基　　金：内蒙古自治区卫生健康委科技计划项目(202201282);内蒙古医科大学2022年度校级本科教学工程项目(NYJTXX202206);内蒙古自治区自然科学基金面上项目(2022LHMS08019);内蒙古医科大学校级储备项目(YKD2022MS023)。

摘　　要：目的探讨患者行胰十二指肠切除术后不同胰管支撑管放置方式对术后胰瘘及住院时间、费用的影响。方法收集内蒙古医科大学附属医院自2017年1月至2023年1月诊治的可行胰十二指肠切除术患者的临床病历资料,根据纳排标准共收集121例,将所收集的资料按照支撑管引流方式分成2组,即支撑管内引流组(A组)、外引流组(B组)。根据胰瘘的相关影响因素具体化分析不同风险人群内、外引流方式对于胰瘘的影响。结果在无风险人群中,内引流胰瘘发生例数(0例)低于外引流(1例),差异无统计学意义(χ^(2)=1.667,P>0.05);在低风险人群中,内引流胰瘘发生例数(2例)等于外引流(2例),差异无统计学意义(χ^(2)=0.393,P>0.05);在中风险人群中,内引流胰瘘发生例数(6例)高于外引流(1例),差异无统计学意义(χ^(2)=1.860,P>0.05),而在高风险人群中内引流胰瘘发生例数(6例)显著高于外引流(0例),差异有统计学意义(χ^(2)=5.058,P<0.05)。A组的住院时间、花费[24.00(21.00,29.30)d、95480.00(82607.25,111883.75)元]都明显低于B组[29.00(24.00,36.00)d、110788.000(90260.00,126770.00)元],差异有统计学意义(Z=-2.882、-1.979,P<0.05)。结论无风险和低中风险人群可选择内引流缩减住院时间、花费,高风险人群可选择外引流减少胰瘘发生率。Objective To investigate the effects of different placement methods of pancreatic duct support tubes on postoperative pancreatic fistula,hospital stay,and cost in patients undergoing pancreaticoduodenectomy.Methods Clinical medical records of feasible patients undergoing pancreaticoduodenectomy treated at Inner Mongolia Medical University Affiliated Hospital from January 2017 to January 2023 were collected.A total of 121 patients were collected according to the inclusion and exclusion criteria,and the collected data were divided into two groups according to the drainage method of the support tube,namely the support tube internal drainage group(Group A)and the external drainage group(Group B).Analyze the impact of internal and external drainage methods on pancreatic fistula in different risk groups based on the relevant influencing factors of pancreatic fistula.Results In the risk-free population,the incidence of pancreatic fistula by internal drainage(0 cases)was lower than that by external drainage(1 case),and the difference was not statistically significant(χ^(2)=1.667,P>0.05).In low-risk population,the incidence of pancreatic fistula by internal drainage(2 cases)was equal to that by external drainage(2 cases),and the difference was not statistically significant(χ^(2)=0.393,P>0.05).In the middle-risk population,the incidence of pancreatic fistula by internal drainage(6 cases)was higher than that by external drainage(1 case),and the difference was not statistically significant(χ^(2)=1.860,P>0.05),while in the high-risk population,the incidence of pancreatic fistula by internal drainage(6 cases)was significantly higher than that by external drainage(0 cases),and the difference was statistically significant(χ^(2)=5.058,P<0.05).The hospitalization time and cost of group A[24.00(21.00,29.30)days,95480.00(82607.25,111883.75)yuan]were significantly lower than those of group B[29.00(24.00,36.00)days,110788.000 yuan,Z=-1.979,P<0.05].Conclusion Non-risk and low-middle risk people can choose internal drainage to reduc

关 键 词：胰管支撑管 胰十二指肠切除术 并发症 术后胰瘘 危险因素 

分 类 号：R657.5[医药卫生—外科学] R656.64[医药卫生—临床医学]