胰十二指肠切除术后胰漏相关危险因素及其预防
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摘要
<正>胰十二指肠切除术(pancreaticoduodenectomy,PD)术后胰漏(postoperative pancreatic fistula,POPF)是胰腺术后最危险的并发症和主要致死原因,严重的POPF还引起腹腔感染、出血、胃排空障碍及败血症等[1]。2016年国际胰腺外科研究组织(international study group on pancreatic surgery,ISGPS)将POPF分为A、B、C级。A级:生化漏,对临床进程无明显影响;B级:胰漏需要术后处理,改变医疗进程,需
引文
[1] Yu L, Huang Q, Xie F, et al. Risk factors of postoperative complications of pancreatoduodenectomy[J]. Hepatogastroenterology,2014,61(135):2091-2095.
[2] Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after[J]. Surgery,2017,161(3):584-591.
[3] Mcmillan MT, Christein JD, Callery MP, et al. Comparing the burden of pancreatic fistulas after pancreatoduodenectomy and distal pancreatectomy[J]. Surgery,2016,159(4):1013-1022.
[4] Hackert T, Hinz U, Pausch T, et al. Postoperative pancreatic fistula:We need to redefine grades B and C[J].Surgery,2016,159(3):872-877.
[5] McMillan MT, Vollmer CM, Asbun HJ, et al. The characterization and prediction of ISGPF grade C fistulas following pancreatoduodenectomy[J]. J Gastrointestinal Surg,2016,20(2):262-276.
[6] Pedrazzoli S. Pancreatoduodenectomy(PD)and postoperative pancreatic fistula(POPF):a systematic review and analysis of the POPF-related mortality rate in 60,739 patients retrieved from the English literature published between 1990 and 2015[J]. Medicine(Baltimore),2017,96(19):e6858.
[7] Noun R, Riachy E, Ghorra C, et al. The impact of obesity on surgical outcome after pancreaticoduodenectomy[J].JOP,2008,9(4):468-476.
[8] Hwang HK, Park JS, Park C, et al. The impact of body mass index on pancreatic fistula after pancreaticoduodenectomy in asian patients on the basis of Asia-Pacific perspective of body mass index[J]. JOP,2011,12(6):586-592.
[9] Park CM, Park JS, Cho ES, et al. The effect of visceral fat mass on pancreatic fistula after pancreaticoduodenectomy[J]. J Invest Surg,2012,25(3):169-173.
[10] Williams TK, Rosato EL, Kennedy EP, et al. Impact of perioperative morbidity and mortality after pancreaticoduodenectomy[J]. J Am Coll Surg,2009,208(2):210-217.
[11] Cristina R, Rachele AM, Francesca G, et al. Morphohistological features of pancreatic stump are the main determinant of pancreatic fistula after pancreatoduodenectomy[J]. Biomed Res Int,2014,2014:641239.
[12] Menahem B, Mulliri A, Bazille C, et al. Body surface area:A new predictive factor of mortality and pancreatic fistula after pancreaticoduodenectomy:A cohort-study[J].Int J Surg,2015,17:83-87.
[13] Rosso E, Casnedi S, Pessaux P, et al. The role of “fatty pancreas” and of BMI in the occurrence of pancreatic fistula after pancreaticoduodenectomy[J]. J Gastrointest Surg,2009,13(10):1845-1851.
[14] Ke Z, Cui J, Hu N, et al. Risk factors for postoperative pancreatic fistula:Analysis of 170 consecutive cases of pancreaticoduodenectomy based on the updated ISGPS classification and grading system[J]. Medicine(Baltimore),2018,97(35):e12151.
[15] Xia X, Huang C, Cen G, et al. Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy:a meta-analysis[J]. Hepatobiliary Pancreatic Dis Int,2015,14(2):132-138.
[16] Mathur A, Pitt HA, Marine M, et al. Fatty pancreas:a factor in postoperative pancreatic fistula[J]. Ann Surg,2007,246(6):1058-1064.
[17]陈涛,胡先贵,金钢,等.胰十二指肠切除术前实验室检查与术后早期并发症相关性分析[J].肝胆胰外科杂志,2010,22(5):378-379.
[18]王伟珅,沈柏用.胰十二指肠切除术后胰瘘危险因素的荟萃分析[J].肝胆外科杂志,2015,23(3):187-193.
[19] Relles DM, Richards NG, Bloom JP, et al. Serum blood urea nitrogen and serum albumin on the first postoperative day predict pancreatic fistula and major complications after pancreaticoduodenectomy[J]. J Gastrointestinal Surg,2013,17(2):326-331.
[20] Pratt WB, Callery MP, Vollmer CM. Risk prediction for development of pancreatic fistula using the ISGPF classification scheme[J]. World J Surg,2008,32(3):419-428.
[21] Dilmurodjon E, Schneider MA, Christoph T, et al. Systematic review and meta-analysis of postoperative pancreatic fistula rates using the updated 2016 International Study Group Pancreatic Fistula definition in patients undergoing pancreatic resection with soft and hard pancreatic texture[J]. HPB(Oxford),2018,20(11):992-1003.
[22] Fu S, Shen S, Li S, et al. Risk factors and outcomes of postoperative pancreatic fistula after pancreaticoduodenectomy:an audit of 532 consecutive cases[J]. BMC Surg,2015,15:34.
[23] Sugimoto M, Takahashi S, Gotohda N, et al. Schematic pancreatic configuration:A risk assessment for postoperative pancreatic fistula after pancreaticoduodenectomy[J].J Gastrointestinal Surg,2013,17(10):1744-1751.
[24] Sakuratani T, Osada S, Tajima JY, et al. Significance of histopathological evaluation of pancreatic fibrosis to predict postoperative course after pancreatic surgery[J]. Pancreatology,2016,16(4):S105-S106.
[25]张志磊,张萌,彭利,等. 350例胰十二指肠切除术后并发症的相关危险因素分析[J].中国现代医学杂志,2017,27(26):75-78.
[26]陈友谊,孙备,姜洪池.胰十二指肠切除术后胰漏的影响因素分析[J].中华外科杂志,2013,51(8):680-684.
[27] Bin X, Lian B, Jianping G, et al. Comparison of patient outcomes with and without stenting tube in pancreaticoduodenectomy[J]. J Int Med Res,2017,46(1):403-410.
[28] Zhou Y, Yang C, Wang S, et al. Does external pancreatic duct stent decrease pancreatic fistula rate after pancreatic resection? A meta-analysis[J]. Pancreatology,2011,11(3):362-370.
[29] Zhang GQ, Li XH, Ye XJ, et al. Internal versus external drainage with a pancreatic duct stent for pancreaticojejunostomy during pancreaticoduodenectomy for patients at high risk for pancreatic fistula:A comparative study[J].J Surg Res,2018,232:247-256.
[30] Ricci C, Casadei R, Taffurelli G, et al. Is pancreaticogastrostomy safer than pancreaticojejunostomy after pancreaticoduodenectomy? A meta-regression analysis of randomized clinical trials[J]. Pancreatology,2017,17(5):805-813.
[31] Qin H, Luo L, Zhu Z, et al. Pancreaticogastrostomy has advantages over pancreaticojejunostomy on pancreatic fistula after pancreaticoduodenectomy. A meta-analysis of randomized controlled trials[J]. Int J Surg,2016,36(Pt A):18-24.
[32] Makni A, Bedioui H, Jouini M, et al. Pancreaticojejunostomy vs. pancreaticogastrostomy following pancreaticoduodenectomy:results of comparative study[J]. Minerva Chi,2011,66(4):295-302.
[33] Osada S, Imai H, Sasaki Y, et al. Reconstruction method after pancreaticoduodenectomy. Idea to prevent serious complications[J]. JOP,2012,13(1):1-6.
[34] Zhang X, Dong X, Liu P, et al. Binding versus conventional pancreaticojejunostomy in preventing postoperative pancreatic fistula:A systematic review and meta-analysis[J]. Dig Surg,2017,34(4):265-280.
[35] Choe YM, Lee KY, Oh CA, et al. Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy[J]. World J Gastroenterol,2008,14(45):6970-6974.
[36] Wang W, Zhang Z, Gu C, et al. The optimal choice for pancreatic anastomosis after pancreaticoduodenectomy:A network meta-analysis of randomized control trials[J]. Int J Surg,2018,57:111-116.
[37] Daamen LA, Jasmijn SF, Besselink MG, et al. A webbased overview, systematic review and meta-analysis of pancreatic anastomosis techniques following pancreatoduodenectomy[J]. HPB(Oxford),2018,20(9):777-785.
[38] Nagakawa Y, Matsudo T, Hijikata Y, et al. Bacterial contamination in ascitic fluid is associated with the development of clinically relevant pancreatic fistula after pancreatoduodenectomy[J]. Pancreas,2013,42(4):701-706.
[39] Sugiura T, Mizuno T, Okamura Y, et al. Impact of bacterial contamination of the abdominal cavity during pancreaticoduodenectomy on surgical-site infection[J]. Br J Surg,2015,102(12):1561-1566.
[40] Yamashita K, Kato D, Sasaki T, et al. Contaminated drainage fluid and pancreatic fistula after pancreatoduodenectomy:A retrospective study[J]. Int J Surg,2018,52:314-319.
[41] Yang F, Jin C, Li J, et al. Clinical significance of drain fluid culture after pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci,2018,25(11):508-517.
[42] De Reuver PR, Gundara J, Hugh TJ, et al. Intra-operative amylase in peri-pancreatic fluid independently predicts for pancreatic fistula post pancreaticoduodectomy[J]. HPB(Oxford),2016,18(7):608-614.
[43] Nahm CB, Brown KM, Townend PJ, et al. Acinar cell density at the pancreatic resection margin is associated with post-pancreatectomy pancreatitis and the development of postoperative pancreatic fistula[J]. HPB(Oxford),2018,20(5):432-440.
[44] Nahm CB, De Reuver PR, Hugh TJ, et al. Intra-operative amylase concentration in peri-pancreatic fluid predicts pancreatic fistula after distal pancreatectomy[J]. J Gastrointestinal Surg,2017,21(6):1031-1037.
[45] Fuks D, Piessen G, Huet E, et al. Life-threatening postoperative pancreatic fistula(grade C)after pancreaticoduodenectomy:incidence, prognosis, and risk factors[J].Am J Surg,2009,197(6):702-709.
[46]楼文晖,刘颖斌,梁廷波,等.胰腺术后外科常见并发症诊治及预防的专家共识(2017)[J].协和医学杂志,2017,8(2-3):139-146.
[47]王伟珅,詹茜,王伟,等.胰十二指肠切除和胰体尾切除术后胰瘘预测的研究[J].外科理论与实践,2018,23(5):440-445.
[48] Yin J, Lu Z, Dai C, et al. Afferent loop decompression technique(ALDT)associate with a reduction of pancreatic fistula following pancreaticoduodenectomy[J]. World J Surg,2016,16(3):S61-S61.
[49] Yang H, Lu XF, Xu YF, et al. Application of air insufflation to prevent clinical pancreatic fistula after pancreaticoduodenectomy[J]. World J Gastroenterol,2015,21(6):1872-1879.
[2] Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after[J]. Surgery,2017,161(3):584-591.
[3] Mcmillan MT, Christein JD, Callery MP, et al. Comparing the burden of pancreatic fistulas after pancreatoduodenectomy and distal pancreatectomy[J]. Surgery,2016,159(4):1013-1022.
[4] Hackert T, Hinz U, Pausch T, et al. Postoperative pancreatic fistula:We need to redefine grades B and C[J].Surgery,2016,159(3):872-877.
[5] McMillan MT, Vollmer CM, Asbun HJ, et al. The characterization and prediction of ISGPF grade C fistulas following pancreatoduodenectomy[J]. J Gastrointestinal Surg,2016,20(2):262-276.
[6] Pedrazzoli S. Pancreatoduodenectomy(PD)and postoperative pancreatic fistula(POPF):a systematic review and analysis of the POPF-related mortality rate in 60,739 patients retrieved from the English literature published between 1990 and 2015[J]. Medicine(Baltimore),2017,96(19):e6858.
[7] Noun R, Riachy E, Ghorra C, et al. The impact of obesity on surgical outcome after pancreaticoduodenectomy[J].JOP,2008,9(4):468-476.
[8] Hwang HK, Park JS, Park C, et al. The impact of body mass index on pancreatic fistula after pancreaticoduodenectomy in asian patients on the basis of Asia-Pacific perspective of body mass index[J]. JOP,2011,12(6):586-592.
[9] Park CM, Park JS, Cho ES, et al. The effect of visceral fat mass on pancreatic fistula after pancreaticoduodenectomy[J]. J Invest Surg,2012,25(3):169-173.
[10] Williams TK, Rosato EL, Kennedy EP, et al. Impact of perioperative morbidity and mortality after pancreaticoduodenectomy[J]. J Am Coll Surg,2009,208(2):210-217.
[11] Cristina R, Rachele AM, Francesca G, et al. Morphohistological features of pancreatic stump are the main determinant of pancreatic fistula after pancreatoduodenectomy[J]. Biomed Res Int,2014,2014:641239.
[12] Menahem B, Mulliri A, Bazille C, et al. Body surface area:A new predictive factor of mortality and pancreatic fistula after pancreaticoduodenectomy:A cohort-study[J].Int J Surg,2015,17:83-87.
[13] Rosso E, Casnedi S, Pessaux P, et al. The role of “fatty pancreas” and of BMI in the occurrence of pancreatic fistula after pancreaticoduodenectomy[J]. J Gastrointest Surg,2009,13(10):1845-1851.
[14] Ke Z, Cui J, Hu N, et al. Risk factors for postoperative pancreatic fistula:Analysis of 170 consecutive cases of pancreaticoduodenectomy based on the updated ISGPS classification and grading system[J]. Medicine(Baltimore),2018,97(35):e12151.
[15] Xia X, Huang C, Cen G, et al. Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy:a meta-analysis[J]. Hepatobiliary Pancreatic Dis Int,2015,14(2):132-138.
[16] Mathur A, Pitt HA, Marine M, et al. Fatty pancreas:a factor in postoperative pancreatic fistula[J]. Ann Surg,2007,246(6):1058-1064.
[17]陈涛,胡先贵,金钢,等.胰十二指肠切除术前实验室检查与术后早期并发症相关性分析[J].肝胆胰外科杂志,2010,22(5):378-379.
[18]王伟珅,沈柏用.胰十二指肠切除术后胰瘘危险因素的荟萃分析[J].肝胆外科杂志,2015,23(3):187-193.
[19] Relles DM, Richards NG, Bloom JP, et al. Serum blood urea nitrogen and serum albumin on the first postoperative day predict pancreatic fistula and major complications after pancreaticoduodenectomy[J]. J Gastrointestinal Surg,2013,17(2):326-331.
[20] Pratt WB, Callery MP, Vollmer CM. Risk prediction for development of pancreatic fistula using the ISGPF classification scheme[J]. World J Surg,2008,32(3):419-428.
[21] Dilmurodjon E, Schneider MA, Christoph T, et al. Systematic review and meta-analysis of postoperative pancreatic fistula rates using the updated 2016 International Study Group Pancreatic Fistula definition in patients undergoing pancreatic resection with soft and hard pancreatic texture[J]. HPB(Oxford),2018,20(11):992-1003.
[22] Fu S, Shen S, Li S, et al. Risk factors and outcomes of postoperative pancreatic fistula after pancreaticoduodenectomy:an audit of 532 consecutive cases[J]. BMC Surg,2015,15:34.
[23] Sugimoto M, Takahashi S, Gotohda N, et al. Schematic pancreatic configuration:A risk assessment for postoperative pancreatic fistula after pancreaticoduodenectomy[J].J Gastrointestinal Surg,2013,17(10):1744-1751.
[24] Sakuratani T, Osada S, Tajima JY, et al. Significance of histopathological evaluation of pancreatic fibrosis to predict postoperative course after pancreatic surgery[J]. Pancreatology,2016,16(4):S105-S106.
[25]张志磊,张萌,彭利,等. 350例胰十二指肠切除术后并发症的相关危险因素分析[J].中国现代医学杂志,2017,27(26):75-78.
[26]陈友谊,孙备,姜洪池.胰十二指肠切除术后胰漏的影响因素分析[J].中华外科杂志,2013,51(8):680-684.
[27] Bin X, Lian B, Jianping G, et al. Comparison of patient outcomes with and without stenting tube in pancreaticoduodenectomy[J]. J Int Med Res,2017,46(1):403-410.
[28] Zhou Y, Yang C, Wang S, et al. Does external pancreatic duct stent decrease pancreatic fistula rate after pancreatic resection? A meta-analysis[J]. Pancreatology,2011,11(3):362-370.
[29] Zhang GQ, Li XH, Ye XJ, et al. Internal versus external drainage with a pancreatic duct stent for pancreaticojejunostomy during pancreaticoduodenectomy for patients at high risk for pancreatic fistula:A comparative study[J].J Surg Res,2018,232:247-256.
[30] Ricci C, Casadei R, Taffurelli G, et al. Is pancreaticogastrostomy safer than pancreaticojejunostomy after pancreaticoduodenectomy? A meta-regression analysis of randomized clinical trials[J]. Pancreatology,2017,17(5):805-813.
[31] Qin H, Luo L, Zhu Z, et al. Pancreaticogastrostomy has advantages over pancreaticojejunostomy on pancreatic fistula after pancreaticoduodenectomy. A meta-analysis of randomized controlled trials[J]. Int J Surg,2016,36(Pt A):18-24.
[32] Makni A, Bedioui H, Jouini M, et al. Pancreaticojejunostomy vs. pancreaticogastrostomy following pancreaticoduodenectomy:results of comparative study[J]. Minerva Chi,2011,66(4):295-302.
[33] Osada S, Imai H, Sasaki Y, et al. Reconstruction method after pancreaticoduodenectomy. Idea to prevent serious complications[J]. JOP,2012,13(1):1-6.
[34] Zhang X, Dong X, Liu P, et al. Binding versus conventional pancreaticojejunostomy in preventing postoperative pancreatic fistula:A systematic review and meta-analysis[J]. Dig Surg,2017,34(4):265-280.
[35] Choe YM, Lee KY, Oh CA, et al. Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy[J]. World J Gastroenterol,2008,14(45):6970-6974.
[36] Wang W, Zhang Z, Gu C, et al. The optimal choice for pancreatic anastomosis after pancreaticoduodenectomy:A network meta-analysis of randomized control trials[J]. Int J Surg,2018,57:111-116.
[37] Daamen LA, Jasmijn SF, Besselink MG, et al. A webbased overview, systematic review and meta-analysis of pancreatic anastomosis techniques following pancreatoduodenectomy[J]. HPB(Oxford),2018,20(9):777-785.
[38] Nagakawa Y, Matsudo T, Hijikata Y, et al. Bacterial contamination in ascitic fluid is associated with the development of clinically relevant pancreatic fistula after pancreatoduodenectomy[J]. Pancreas,2013,42(4):701-706.
[39] Sugiura T, Mizuno T, Okamura Y, et al. Impact of bacterial contamination of the abdominal cavity during pancreaticoduodenectomy on surgical-site infection[J]. Br J Surg,2015,102(12):1561-1566.
[40] Yamashita K, Kato D, Sasaki T, et al. Contaminated drainage fluid and pancreatic fistula after pancreatoduodenectomy:A retrospective study[J]. Int J Surg,2018,52:314-319.
[41] Yang F, Jin C, Li J, et al. Clinical significance of drain fluid culture after pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci,2018,25(11):508-517.
[42] De Reuver PR, Gundara J, Hugh TJ, et al. Intra-operative amylase in peri-pancreatic fluid independently predicts for pancreatic fistula post pancreaticoduodectomy[J]. HPB(Oxford),2016,18(7):608-614.
[43] Nahm CB, Brown KM, Townend PJ, et al. Acinar cell density at the pancreatic resection margin is associated with post-pancreatectomy pancreatitis and the development of postoperative pancreatic fistula[J]. HPB(Oxford),2018,20(5):432-440.
[44] Nahm CB, De Reuver PR, Hugh TJ, et al. Intra-operative amylase concentration in peri-pancreatic fluid predicts pancreatic fistula after distal pancreatectomy[J]. J Gastrointestinal Surg,2017,21(6):1031-1037.
[45] Fuks D, Piessen G, Huet E, et al. Life-threatening postoperative pancreatic fistula(grade C)after pancreaticoduodenectomy:incidence, prognosis, and risk factors[J].Am J Surg,2009,197(6):702-709.
[46]楼文晖,刘颖斌,梁廷波,等.胰腺术后外科常见并发症诊治及预防的专家共识(2017)[J].协和医学杂志,2017,8(2-3):139-146.
[47]王伟珅,詹茜,王伟,等.胰十二指肠切除和胰体尾切除术后胰瘘预测的研究[J].外科理论与实践,2018,23(5):440-445.
[48] Yin J, Lu Z, Dai C, et al. Afferent loop decompression technique(ALDT)associate with a reduction of pancreatic fistula following pancreaticoduodenectomy[J]. World J Surg,2016,16(3):S61-S61.
[49] Yang H, Lu XF, Xu YF, et al. Application of air insufflation to prevent clinical pancreatic fistula after pancreaticoduodenectomy[J]. World J Gastroenterol,2015,21(6):1872-1879.