在机器人远端胰腺切除术中，肝韧带皮瓣加固对预防术后胰瘘的作用。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-08-13 DOI:10.1016/j.amjsurg.2024.115894

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引用次数: 0

摘要

背景：术后胰瘘（POPF）是机器人远端胰腺切除术（RDP）后发病率和死亡率的重要因素。肝韧带（LTH）加固胰腺残余可降低 POPF 的发生率：方法：2018 年 1 月 1 日至 2022 年 8 月 31 日期间在马萨诸塞大学纪念医学中心接受 RDP 的年龄≥18 岁的患者。主要终点为 POPF 发生率。次要结果包括围手术期和术后变量：33 名患者接受了 RDP，其中 21 例（64%）使用了 LTH 加固术。6例（18%）患者出现了POPF。未发现 LTH 皮瓣加固与 POPF 之间存在关联（OR 1.18，95 % CI 0.18 至 7.85，p = 0.87）。术前和术后均未出现与韧带瓣创建相关的并发症：结论：胰腺残余的LTH加固可以在RDP手术中安全进行。结论：胰腺残端 LTH 加固术可以在 RDP 期间安全地进行，还需要进一步的研究来评估这种干预对降低 RDP 后胰瘘形成风险的作用。

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Utility of ligamentum teres hepatis flap reinforcement to prevent postoperative pancreatic fistulas in robotic distal pancreatectomy

Background

Postoperative pancreatic fistula (POPF) is a significant contributor to morbidity and mortality after robotic distal pancreatectomy (RDP). Ligamentum teres hepatis (LTH) reinforcement of the pancreatic remnant may reduce the incidence of POPF.

Methods

Patients ≥18 years old, who underwent RDP at the University of Massachusetts Memorial Medical Center from 01/01/2018-08/31/2022. Primary endpoint was POPF incidence. Secondary outcomes included peri- and postoperative variables.

Results

Thirty-three patients underwent RDP, of which LTH reinforcement was used in 21 (64 %) cases. Six (18 %) patients developed a POPF. No association was identified between LTH flap reinforcement and POPF (OR 1.18, 95 % CI 0.18 to 7.85, p = 0.87). There were no peri- or postoperative complications related to ligamentum teres flap creation.

Conclusions

LTH reinforcement of the pancreatic remnant can be safely performed during RDP. Further studies are needed to assess the utility of this intervention to mitigate the risk of pancreatic fistula formation following RDP.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.