腹腔镜胰腺远端切除术后炎症状态的优势。

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2024-10-09 DOI:10.1159/000541449

Saori Funakoshi, Yutaka Suzuki, Masao Yoshida, Hirokazu Momose, Ryota Matsuki, Masaharu Kogure, Nobutsugu Abe, Eiji Sunami, Yoshihiro Sakamoto

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引用次数: 0

摘要

引言腹腔镜胰腺远端切除术（LDP）是一种安全有效的手术，但与开腹胰腺远端切除术（ODP）相比，其对围术期炎症反应的影响仍不明确。本研究旨在评估 LDP 和 ODP 术后炎症反应的短期疗效。方法这项回顾性研究对 2005 年至 2022 年间因低度恶性肿瘤接受远端胰腺切除术的 77 例连续患者进行了研究，比较了 LDP 和 ODP 的白细胞（WBC）计数、C 反应蛋白（CRP）水平、血清白蛋白水平和 CRP/albumin 比值（CAR）。此外，还比较了并发症，尤其是术后胰瘘（POPF）、恢复方案和住院时间。结果 LDP 的胰瘘（17.1% 对 38.7%，P = 0.039）和手术发病率（≥Clavien-Dindo III 级，12.2% 对 32.3%，P = 0.038）明显低于 ODP，而术后炎症反应（包括 CRP 和 CAR）的差异只是暂时的。通过多变量分析，POD 3 的 CAR≥6.94 是 POPF 的重要预测因子（42.1% vs. 13.2%，Odds ratio 4.828，p=0.030）。CAR 可以预测 POPF。

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Advantage of Postoperative Inflammatory Status after Laparoscopic Distal Pancreatectomy.

Introduction: Laparoscopic distal pancreatectomy (LDP) is a safe and effective procedure; however, its impact on perioperative inflammatory reactions compared with open distal pancreatectomy (ODP) remains unclear. This study aimed to assess short-term outcomes following LDP and ODP regarding inflammatory reactions.

Methods: This retrospective study of 77 consecutive patients who underwent distal pancreatectomy for low-grade malignancies between 2005 and 2022 compared white blood cell (WBC) count, C-reactive protein (CRP) level, serum albumin level, and CRP/albumin ratio (CAR) between LDP and ODP. Complications, especially postoperative pancreatic fistula (POPF), recovery program, and hospital stay period, were also compared.

Results: POPF (17.1% vs. 38.7%, p = 0.039) and surgical morbidity (≥Clavien-Dindo grade III, 12.2% vs. 32.3%, p = 0.038) were significantly lower in LDP than in ODP, as for the difference in postoperative inflammatory response, including CRP and CAR, was just temporary. By multivariate analysis, CAR ≥6.94 on POD 3 was significant predictor of POPF (42.1% vs. 13.2%, odds ratio 4.828, p = 0.030).

Conclusion: LDP has lower POPF and earlier postoperative recovery. CAR could be a predictor of POPF.

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.