{"title":"胰十二指肠切除术胰消化吻合术的优化引流","authors":"N. Mena, Polina Marinova-Kichikova, K. Kirov","doi":"10.2478/jbcr-2022-0019","DOIUrl":null,"url":null,"abstract":"Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"43 1","pages":"135 - 141"},"PeriodicalIF":0.0000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimized Drainage of Pancreatic-Digestive Anastomosis in Patients with Pancreatoduodenal Resection\",\"authors\":\"N. Mena, Polina Marinova-Kichikova, K. Kirov\",\"doi\":\"10.2478/jbcr-2022-0019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.\",\"PeriodicalId\":15099,\"journal\":{\"name\":\"Journal of Biomedical and Clinical Research\",\"volume\":\"43 1\",\"pages\":\"135 - 141\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Biomedical and Clinical Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2478/jbcr-2022-0019\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Biomedical and Clinical Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2478/jbcr-2022-0019","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Optimized Drainage of Pancreatic-Digestive Anastomosis in Patients with Pancreatoduodenal Resection
Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.