Cattel和Blumgart吻合术:胰腺癌患者胰空肠吻合术技术的比较。

Current health sciences journal Pub Date : 2024-01-01 Epub Date: 2024-03-31 DOI:10.12865/CHSJ.50.01.03
Sergio Isidro Gamboa-Hoil, Ricardo Gamboa-Gutierrez, Patricia Bolado-Garcia, Alejandro Medina-Campos
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引用次数: 0

摘要

背景:胰空肠吻合术发生胰漏的风险很高,目前已有多种手术技术可供参考。我们的主要目的是根据所使用的胰空肠吻合技术(Cattel 与 Blumgart),确定接受胰十二指肠切除术的患者术后胰漏的相关性。2020年4月至2021年5月,采用Cattel技术;2021年6月至2022年6月,采用Blumgart技术。所有手术均由肿瘤医院的一名获得董事会认证的肿瘤外科医生实施。前 9 个手术采用 Cattel 技术,从第 10 个手术开始采用 Blumgart 技术。两组患者的胰腺一致性(P=0.28)和胰管大小(P=0.51)均无差异。卡特尔技术100%观察到胰腺渗漏,布隆加特技术6.7%观察到胰腺渗漏(p= 0.0001)。使用 Cattel 技术时,6 天后左侧引流管中的淀粉酶值大于 200 U/L,而使用 Blumgart 技术时则小于 200 U/L(P=0.0001)。术中出血量(Cattel 1200 毫升对 Blumgart 400 毫升,P= 0.03)和 90 天死亡率(Cattel 33.3% 对 Blumgart 0%,Log-Rank:0.022)也显示出 Blumgart 技术更胜一筹。布隆加特技术是出现胰腺漏的保护因素(RR 0.06,95% CI 0.01-0.44,P=0.0001):讨论:与 Cattel 技术相比,使用 Blumgart 技术发生胰腺漏的风险更低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cattel and Blumgart Anastomosis: Comparison of Pancreatojejunostomy Techniques in Patients with Pancreatic Cancer.

Backround: Pancreaticojejunal anastomosis has a high risk of pancreatic leakage, which several surgical techniques have been described. Our main objective is to determine what is the association of postoperative pancreatic leakage in patients undergoing pancreaticoduodenectomy according to the pancreaticojejunal anastomosis technique used (Cattel vs Blumgart)?

Material and methods: Historical cohort, all cancer patients undergoing pancreaticoduodenectomy were included. From April 2020 to May 2021, Cattel technique was used; from June 2021 to June 2022, Blumgart technique was used. All procedures were performed by a single board-certified surgical oncologist at Oncology Hospital.

Results: 24 patients (11 men and 13 women). The first 9 procedures were performed with the Cattel technique, starting from procedure 10, the Blumgart technique was used. No differences were observed regarding the consistency of the pancreas (p=0.28) or the size of the duct (p=0.51) between the two groups. Pancreatic leakage was observed in 100% with the Cattel technique and in 6.7% with the Blumgart technique (p= 0.0001). An amylase value was observed in the left drainage at 6 days > 200 U/L with the Cattel technique and < 200 U/L with Blumgart (p=0.0001). Intraoperative bleeding (Cattel 1200 ml vs. Blumgart 400 ml, p= 0.03) and 90-day mortality (Cattel 33.3% vs. Blumgart 0%, Log-Rank: 0.022) also showed a difference in favor of Blumgart technique. Blumgart technique is a protective factor for the presence of pancreatic leakage (RR 0.06, 95% CI 0.01-0.44, p=0.0001).

Discussion: A lower risk of pancreatic leakage was found using the Blumgart technique, compared to the Cattel technique.

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