Jialin Li, Jie Hua, Haiyan Ruan, Hang Xu, Chen Liang, QingCai Meng, Jiang Liu, Bo Zhang, Jin Xu, Si Shi, XianJun Yu, Wei Wang
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引用次数: 0
Abstract
Background: Abdominal fluid collection (AFC) is one of the most common complications after pancreatic surgery, yet there are few recommendations on how to manage it. Most cases of AFC only require observation, while others may require more invasive techniques. Unfortunately, there are no drugs that effectively promote the absorption of AFCs. The aim of this study was to evaluate the potential efficacy of Glauber's salt solution for promoting the absorption of AFCs after pancreatectomy.
Methods: This study included 196 patients who underwent pancreatomy and had AFCs on at least 2 cross-sectional follow-up CT images between 2020 and 2022. AFCs were defined as effusion with a diameter ≥ 3 cm and located around the pancreatic resection margin. We retrospectively investigated the relationship between Glauber's salt concentration and clinical variables.
Results: The rate of clinically significant pancreatic fistula (grades B + C) was significantly higher in the control group (62.8% vs. 40.7%, P = 0.014). The median maximum diameter of the AFC was smaller, and the median time for the AFC to decrease to 30 mm in diameter was shorter in the Glauber's salt group than in the control group (41.9 mm vs. 53.5 mm, P = 0.008; 35.5 d vs. 100 d, P < 0.001). According to the multivariate analysis, percutaneous drainage and the application of Glauber's salt were found to be independent risk factors for AFCs decreasing to less than 30 mm in diameter (HR = 2.338, 95% CI = 1.524-3.585, P < 0.001; HR = 1.853, 95% CI = 1.327-2.589, P < 0.001). Additionally, patients with a maximum postoperative temperature exceeding 38.5 °C exhibited enhanced AFC absorption (hazard ratio (HR) = 1.850, 95% CI = 1.268-2.701; P = 0.001).
Conclusions: Topical application of Glauber's salt solution after pancreatic surgery can promote the absorption of AFCs.
背景:腹部积液(AFC)是胰腺手术后最常见的并发症之一,但目前关于如何处理它的建议很少。大多数AFC病例只需要观察,而其他病例可能需要更多的侵入性技术。不幸的是,没有药物可以有效地促进afc的吸收。本研究的目的是评估格劳伯盐溶液促进胰腺切除术后AFCs吸收的潜在功效。方法:本研究纳入196例在2020年至2022年期间接受胰腺切除术并在至少2个横断面随访CT图像上出现AFCs的患者。AFCs定义为直径≥3cm且位于胰腺切除边缘周围的积液。我们回顾性调查了格劳伯盐浓度与临床变量的关系。结果:对照组临床显著性胰瘘(B + C级)发生率明显高于对照组(62.8% vs. 40.7%, P = 0.014)。格劳伯盐组AFC的中位最大直径更小,AFC减小到直径30 mm的中位时间也比对照组短(41.9 mm比53.5 mm, P = 0.008;结论:胰腺手术后局部应用格劳勃盐溶液可促进AFCs的吸收。