慢性阻塞性肺病对胰十二指肠切除术后并发症风险的影响--一项单中心队列研究。

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2024-10-11 DOI:10.1016/j.hpb.2024.10.005

Patrik Larsson, Oskar Swartling, Giampaolo Perri, Kaveh Vaez, Marcus Holmberg, Fredrik Klevebro, Stefan Gilg, Ernesto Sparrelid, Poya Ghorbani

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引用次数: 0

摘要

背景：慢性阻塞性肺疾病（COPD）与胰腺手术后并发症风险之间的关系尚未明确。本研究旨在探讨慢性阻塞性肺病是否与胰十二指肠切除术后并发症风险增加有关：方法：纳入2008年至2019年期间在一家胰腺癌手术量较大的三级中心接受胰十二指肠切除术的所有年龄≥18岁的患者。根据《国际疾病统计分类》，慢性阻塞性肺病被定义为已确诊的疾病。主要结果为Clavien-Dindo评分（CD）≥ IIIa：在 1009 名患者中，有 57 人（5.6%）被诊断为慢性阻塞性肺病。慢性阻塞性肺病与 CD≥ IIIa 之间没有关联（25.5% 对 29.8%，P 值 0.471）。慢性阻塞性肺病与术后胰瘘 (POPF) 的风险增加有关（几率比 [OR] 3.06，95% 置信区间 1.62-5.89；P 结论：慢性阻塞性肺病与术后胰瘘的风险增加有关：慢性阻塞性肺病与 POPF 风险增加有关。这些结果表明，在被认为适合接受手术的患者中，在进行风险分层时应全面评估慢性阻塞性肺病。

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The impact of chronic obstructive pulmonary disease on risk for complications after pancreatoduodenectomy - a single centre cohort study.

Background: The association between chronic obstructive pulmonary disease (COPD) and risk for postoperative complications after pancreatic surgery has not been clarified. The aim of this study was to investigate if COPD is associated with increased risk for postoperative complications after pancreatoduodenectomy.

Methods: All patients aged ≥18 years undergoing pancreatoduodenectomy from 2008 to 2019 at a high-volume tertiary centre for pancreatic cancer surgery were included. COPD was defined as an established diagnosis according to the International Statistical Classification of Diseases. The primary outcome was Clavien-Dindo-score (CD)≥ IIIa.

Results: Out of 1009 available patients, 57 (5.6 %) had a diagnosis of COPD. There was no association between COPD and CD≥ IIIa (25.5 % vs. 29.8 % p-value 0.471). COPD was associated with an increased risk for postoperative pancreatic fistula (POPF) (odds ratio [OR] 3.06, 95 % confidence interval 1.62-5.89; p < 0.001). The 12 months mortality rate was higher among patients with COPD compared to patients without COPD, although not statistically significant (28.07 % vs., 18.17 %, p-value = 0.063).

Conclusion: COPD was associated with increased risk for POPF. These results imply that among patients deemed fit enough to undergo surgery, COPD should be thoroughly evaluated in the risk stratification.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

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).