胰十二指肠切除术中肝动脉血流的术中评价(HEPARFLOW):一项探索性研究的方案

IF 1.1 Q3 SURGERY
Mohammed Al-Saeedi , Leonie Frank-Moldzio , Miriam Klauß , Philipp Mayer , Tom Bruckner , Elias Khajeh , Mohammad Golriz , Arianeb Mehrabi , Phillip Knebel , Markus K. Diener , Markus W. Büchler , Oliver Strobel
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引用次数: 1

摘要

胰十二指肠切除术是一系列良性和恶性疾病的治疗选择。胰头在手术中必须与胰头的供应血管,特别是胃十二指肠动脉分开。然而,胃十二指肠动脉的剥离会扰乱肝脏的血液供应,导致肝脏缺血。目前还没有完善的算法来评估和确保肝动脉血流改变患者有足够的血流。为了解决这一重要问题,本研究旨在为胰十二指肠切除术中肝血供评估奠定基础。此外,还将评估影响动脉血流的因素及相关的术后并发症。HEPARFLOW研究是一项单机构单臂前瞻性探索性观察性临床试验。所有连续接受选择性部分或全部胰十二指肠切除术的患者将被筛选纳入,直到100例患者入选。在胰十二指肠切除术中,使用多普勒血流仪测量肝固有动脉、胃十二指肠动脉、门静脉和供应肝脏的其他血管的血流。所有患者术后随访90天。每次就诊时,记录标准临床资料、术后并发症和死亡率。这将是第一个前瞻性评估胰十二指肠切除术中肝动脉和门静脉血流率以评估肝脏血液供应的研究。术前和术中影响肝动脉血流的因素将被确定。本研究也可能揭示胰十二指肠切除术时腹腔轴受压的血流动力学和临床意义。伦理与传播本研究获得海德堡大学伦理委员会批准(S-073/2018)。研究结果将发表在同行评议的期刊上,并将在医学会议上发表。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Intraoperative evaluation of hepatic artery blood flow during pancreatoduodenectomy (HEPARFLOW): Protocol of an exploratory study

Intraoperative evaluation of hepatic artery blood flow during pancreatoduodenectomy (HEPARFLOW): Protocol of an exploratory study

Intraoperative evaluation of hepatic artery blood flow during pancreatoduodenectomy (HEPARFLOW): Protocol of an exploratory study

Introduction

Pancreatoduodenectomy is the treatment of choice for a range of benign and malignant diseases. The pancreatic head must be separated from its supplying vessels, especially the gastroduodenal artery, during this operation. However, dissection of the gastroduodenal artery can disturb blood supply to the liver and result in liver ischemia. There is currently no well-established algorithm to evaluate and ensure sufficient blood flow in patients with altered hepatic artery blood flow. To address this important issue, this study aims to establish a basis for assessing liver blood supply during pancreatoduodenectomy. Furthermore, factors influencing arterial blood flow and related postoperative complications will be evaluated.

Methods and analysis

The HEPARFLOW study is a single institutional single-arm prospective exploratory observational clinical trial. All consecutive patients undergoing elective partial or total pancreatoduodenectomy will be screened for inclusion until 100 patients are enrolled. Blood flow in the proper hepatic artery, gastroduodenal artery, portal vein, and additional vessels supplying the liver will be measured during pancreatoduodenectomy using Doppler flowmetry. All patients will be followed up for 90 days after surgery. At each visit, standard clinical data, postoperative complications and mortality will be recorded.

Discussion

This will be the first study to prospectively assess intraoperative flow rates of the hepatic artery and portal vein to evaluate liver blood supply during pancreatoduodenectomy. The preoperative and intraoperative factors influencing blood flow in the hepatic arteries will be identified. This study may also reveal the hemodynamic and clinical relevance of a compression of the celiac axis during pancreatoduodenectomy.

Ethics and dissemination

This study was approved by the Ethics Committee of the University of Heidelberg (S-073/2018). The results will be published in a peer-reviewed journal and will be presented at medical meetings.

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期刊介绍: IJS Protocols is the first peer-reviewed, international, open access journal seeking to publish research protocols across across the full breadth of the surgical field. We are aim to provide rapid submission to decision times whilst maintaining a high quality peer-review process.
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