脾静脉切除并不是胰十二指肠切除术合并门静脉或肠系膜上静脉切除后胃排空延迟的危险因素。

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-10-01 Epub Date: 2025-04-18 DOI:10.1007/s00595-025-03032-y

Koki Maeda, Naohisa Kuriyama, Motonori Nagata, Yasutaka Ichikawa, Maito Tachibana, Tatsuya Sakamoto, Benson Kaluba, Haruna Komatsubara, Daisuke Noguchi, Takahiro Ito, Kazuyuki Gyoten, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Akihiro Tanemura, Masashi Kishiwada, Shugo Mizuno

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引用次数: 0

摘要

目的：探讨脾静脉（SV）对胰十二指肠切除术（PD）联合门静脉（PV）和肠系膜上静脉（SMV）切除患者胃延迟排空（DGE）的影响。方法：选取147例行开放式保胃次全胰十二指肠切除术（SSPPD）合并PV/SMV切除的患者，分为SV切除组（101例）和保留组（46例）。比较两组间DGE的发生率。采用单因素和多因素分析来确定DGE的危险因素。结果：SV切除组和保留组之间B级或C级DGE的发生率无显著差异(分别为19.8%和19.6%；p = 0.973)。多因素分析显示腹腔内脓肿(优势比，3.355；95%置信区间为1.324-8.500；p = 0.011)是DGE的唯一独立危险因素。结论：SV切除不影响PV/SMV切除的SSPPD后DGE的发生率。可能没有必要出于对DGE的关注而坚持保留与胃静脉流动相关的静脉。

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Splenic vein resection is not a risk factor for delayed gastric emptying after pancreaticoduodenectomy with combined resection of the portal or superior mesenteric vein.

Purpose: This study clarified the influence of the splenic vein (SV) on delayed gastric emptying (DGE) in patients who underwent pancreaticoduodenectomy (PD) combined with portal vein (PV) and superior mesenteric vein (SMV) resections.

Methods: A total of 147 patients who underwent open subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) with PV/SMV resection were included in this study and classified into two groups: SV resection (n = 101) and preservation (n = 46). The incidence of DGE was compared between groups. Univariate and multivariate analyses were used to identify the risk factors for DGE.

Results: There was no significant difference in the incidence of Grade B or C DGE between the SV resection and preservation groups (19.8 vs. 19.6%, respectively; p = 0.973). Multivariate analysis revealed that intra-abdominal abscess (odds ratio, 3.355; 95% confidence interval, 1.324-8.500; p = 0.011) was the only independent risk factor for DGE.

Conclusion: SV resection did not affect the incidence of DGE after SSPPD with PV/SMV resection. There may be no need to insist on preserving the veins associated with gastric venous flow out of concern for DGE.

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.