{"title":"胰腺移植部位对远端胰腺切除术后胰腺纤维瘤发生率的影响：倾向得分匹配研究","authors":"","doi":"10.1016/j.hpb.2024.05.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Distal pancreatectomy (DP) is performed for lesions in the body and tail of the pancreas. The morbidity profile is considerable, mainly due to clinically relevant postoperative pancreatic fistula (CR-POPF). This study aims to investigate potential differences in CR-POPF related to transection site.</p></div><div><h3>Methods</h3><p>An observational cohort study from a prospectively maintained database was performed. Subtotal distal pancreatectomy (SDP) was defined as transection over the superior mesenteric vein, and DP was defined as transection lateral to this point. Propensity score matching (PSM) in 1:1 fashion was applied based on demographical and perioperative variables.</p></div><div><h3>Results</h3><p>Six hundred and six patients were included in the analysis (1997–2020). Four hundred twenty (69.3%) underwent DP, while 186 (30.7%) underwent SDP. The rate of CR-POPF was 19.3% after DP and 20.4% after SDP (p = 0.74). SDP was associated with older age (63.1 vs 60.1 years, p = 0.016), higher occurrence of ductal adenocarcinoma (37.1 vs 17.6%, p = 0.001) and more frequent use of neoadjuvant chemotherapy (3.8 vs 0.7%, p = 0.012). After PSM, 155 patients were left in each group. The difference in CR-POPF between DP and SDP remained statistically non-significant (20.6 vs 18.7%, p = 0.67).</p></div><div><h3>Conclusion</h3><p>This study found no difference in CR-POPF related to transection site during distal pancreatectomy.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1164-1171"},"PeriodicalIF":2.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1365182X24017386/pdfft?md5=bbc1133a0cb52c705bfc72b864c78a7c&pid=1-s2.0-S1365182X24017386-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Impact of pancreas transection site on incidence of pancreatic fistula after distal pancreatectomy: a propensity score matched study\",\"authors\":\"\",\"doi\":\"10.1016/j.hpb.2024.05.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Distal pancreatectomy (DP) is performed for lesions in the body and tail of the pancreas. The morbidity profile is considerable, mainly due to clinically relevant postoperative pancreatic fistula (CR-POPF). This study aims to investigate potential differences in CR-POPF related to transection site.</p></div><div><h3>Methods</h3><p>An observational cohort study from a prospectively maintained database was performed. Subtotal distal pancreatectomy (SDP) was defined as transection over the superior mesenteric vein, and DP was defined as transection lateral to this point. Propensity score matching (PSM) in 1:1 fashion was applied based on demographical and perioperative variables.</p></div><div><h3>Results</h3><p>Six hundred and six patients were included in the analysis (1997–2020). Four hundred twenty (69.3%) underwent DP, while 186 (30.7%) underwent SDP. The rate of CR-POPF was 19.3% after DP and 20.4% after SDP (p = 0.74). SDP was associated with older age (63.1 vs 60.1 years, p = 0.016), higher occurrence of ductal adenocarcinoma (37.1 vs 17.6%, p = 0.001) and more frequent use of neoadjuvant chemotherapy (3.8 vs 0.7%, p = 0.012). After PSM, 155 patients were left in each group. The difference in CR-POPF between DP and SDP remained statistically non-significant (20.6 vs 18.7%, p = 0.67).</p></div><div><h3>Conclusion</h3><p>This study found no difference in CR-POPF related to transection site during distal pancreatectomy.</p></div>\",\"PeriodicalId\":13229,\"journal\":{\"name\":\"Hpb\",\"volume\":\"26 9\",\"pages\":\"Pages 1164-1171\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1365182X24017386/pdfft?md5=bbc1133a0cb52c705bfc72b864c78a7c&pid=1-s2.0-S1365182X24017386-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hpb\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1365182X24017386\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1365182X24017386","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景远端胰腺切除术（DP）适用于胰腺体部和尾部的病变。其发病率相当高，主要是由于与临床相关的术后胰瘘（CR-POPF）。本研究旨在探讨 CR-POPF 与横断部位相关的潜在差异。胰腺远端次全切除术（SDP）定义为在肠系膜上静脉上方横断，DP定义为在该点外侧横断。根据人口统计学和围手术期变量，以 1:1 的方式进行倾向评分匹配 (PSM)。其中 42 人（69.3%）接受了 DP，186 人（30.7%）接受了 SDP。DP 后 CR-POPF 的发生率为 19.3%，SDP 后为 20.4%（P = 0.74）。SDP与年龄较大（63.1 岁 vs 60.1 岁，p = 0.016）、导管腺癌发生率较高（37.1% vs 17.6%，p = 0.001）和更频繁使用新辅助化疗（3.8% vs 0.7%，p = 0.012）有关。PSM 后，两组各剩下 155 名患者。DP和SDP的CR-POPF差异仍无统计学意义（20.6 vs 18.7%，p = 0.67）。
Impact of pancreas transection site on incidence of pancreatic fistula after distal pancreatectomy: a propensity score matched study
Background
Distal pancreatectomy (DP) is performed for lesions in the body and tail of the pancreas. The morbidity profile is considerable, mainly due to clinically relevant postoperative pancreatic fistula (CR-POPF). This study aims to investigate potential differences in CR-POPF related to transection site.
Methods
An observational cohort study from a prospectively maintained database was performed. Subtotal distal pancreatectomy (SDP) was defined as transection over the superior mesenteric vein, and DP was defined as transection lateral to this point. Propensity score matching (PSM) in 1:1 fashion was applied based on demographical and perioperative variables.
Results
Six hundred and six patients were included in the analysis (1997–2020). Four hundred twenty (69.3%) underwent DP, while 186 (30.7%) underwent SDP. The rate of CR-POPF was 19.3% after DP and 20.4% after SDP (p = 0.74). SDP was associated with older age (63.1 vs 60.1 years, p = 0.016), higher occurrence of ductal adenocarcinoma (37.1 vs 17.6%, p = 0.001) and more frequent use of neoadjuvant chemotherapy (3.8 vs 0.7%, p = 0.012). After PSM, 155 patients were left in each group. The difference in CR-POPF between DP and SDP remained statistically non-significant (20.6 vs 18.7%, p = 0.67).
Conclusion
This study found no difference in CR-POPF related to transection site during distal pancreatectomy.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
Abstracted and Indexed in:
MEDLINE®
EMBASE
PubMed
Science Citation Index Expanded
Academic Search (EBSCO)
HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
