Incidence and outcomes of postoperative fluid collections after minimally invasive distal pancreatectomy without placement of surgical drain. A prospective observational cohort study

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-03-22 DOI:10.1002/jhbp.1423
Núria Lluís, Filipe Kunzler, Domenech Asbun, Ramon E. Jimenez, Horacio J. Asbun
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Abstract

Background/Purpose

There is uncertainty about the role of prophylactic intra-abdominal drains after distal pancreatectomy. In the present study, we aimed to describe the long-term outcomes of postoperative pancreatic collections in patients who underwent a minimally invasive distal pancreatectomy (MIDP) without surgical drain placement.

Methods

From 2018 to 2022, consecutive patients who underwent a MIDP were recorded. Patients were followed at 90 days, 6 months, and in the long term. The use of interventional procedures and antibiotic therapy were documented, and the overall evolution of the collections was assessed.

Results

A total of 91 patients underwent MIDP; 11 were excluded; 80 were analyzed. Median age was 63 (51–73) years; 61.3% were women. Most lesions (71.3%) were malignant; 15 patients received neoadjuvant therapy. Procedures were laparoscopic (87.5%) or robotic (12.5%). Incidence of postoperative pancreatic collections was 33%; 10 patients were symptomatic. Interventional endoscopic (n = 3) or percutaneous (n = 3) procedures were required. At a follow-up of 24 (17.5–33.1) months, 18 collections resolved completely, eight partially, and one increased.

Conclusions

Patients who undergo MIDP without surgical drain placement develop well-tolerated pancreatic collections. Although a minority may require endoscopic or percutaneous drainage, the majority can be managed conservatively and resolve spontaneously in the long term.

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不放置手术引流管的微创胰腺远端切除术后积液的发生率和预后。前瞻性观察队列研究。
背景/目的:远端胰腺切除术后预防性腹腔内引流的作用尚不确定。在本研究中,我们旨在描述接受微创远端胰腺切除术(MIDP)而未放置手术引流管的患者术后胰腺积液的长期预后:从2018年到2022年,记录了连续接受MIDP的患者。对患者进行了 90 天、6 个月和长期随访。记录了介入手术和抗生素治疗的使用情况,并评估了收集的总体演变情况:共有 91 名患者接受了 MIDP,其中 11 人被排除在外,80 人接受了分析。中位年龄为63(51-73)岁;61.3%为女性。大多数病变(71.3%)为恶性;15名患者接受了新辅助治疗。手术方式为腹腔镜(87.5%)或机器人(12.5%)。术后胰腺积液发生率为33%;10名患者出现症状。需要进行介入内镜手术(3 例)或经皮手术(3 例)。随访24(17.5-33.1)个月后,18例胰腺积液完全消退,8例部分消退,1例增加:结论:接受 MIDP 而不进行外科引流管置入术的患者可以很好地耐受胰腺积液。虽然少数患者可能需要内镜或经皮引流,但大多数患者可以采取保守治疗,并在长期内自行消退。
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CiteScore
7.20
自引率
4.30%
发文量
567
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