{"title":"肝部分切除术后胃肠功能延迟恢复:一项单中心横断面研究。","authors":"Giulia Piazza, Ismail Labgaa, Emilie Uldry, Emmanuel Melloul, Nermin Halkic, Gaëtan-Romain Joliat","doi":"10.1159/000542028","DOIUrl":null,"url":null,"abstract":"<p><p>Introduction Partial hepatectomy (PH) remains associated with complication rates around 30-50%. Delayed return of gastrointestinal function (DRGF) has been reported in 10-20%. This study aimed to assess DRGF predictors after PH. Aim This retrospective study aimed to assess DRGF predictors after PH. Methods All patients who underwent PH between 01/2010 and 12/2019 were included. DRGF was defined as need of postoperative nasogastric tube (NGT). Independent DRGF predictors were identified with multivariable logistic binary regression. Results Overall, 501 patients were included. DRGF occurred in 82 patients (16%). A hundred-and-twelve patients (22%) underwent a minimally invasive approach and DRGF incidence was significantly lower in this group (p <0.001). DRGF was more frequent after major PH (p<0.001). DRGF occurred more often in patients with preoperative embolization (p<0.001), biliary anastomosis (p<0.001) and extrahepatic resection (p<0.001). Patients with DRGF had longer median operation duration (p<0.001), more biliary leaks/bilomas (p<0.001) and higher median blood loss (p<0.001). DRGF patients developed more pneumonias (p<0.001) and had longer median length of stay (p<0.001). On multivariable analysis, operation duration (p<0.001), major hepatectomy (p<0.001) and postoperative biloma/biliary leak (p<0.001) were independently associated with DRGF occurrence. Conclusion Postoperative DRGF occurred in 16% of the patients and was associated with longer length of stay. Surgery duration, major PH and postoperative biloma/biliary leak were found as independent predictors of DRGF.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-16"},"PeriodicalIF":1.8000,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Delayed return of gastrointestinal function after partial hepatectomy: a single-center cross-sectional study.\",\"authors\":\"Giulia Piazza, Ismail Labgaa, Emilie Uldry, Emmanuel Melloul, Nermin Halkic, Gaëtan-Romain Joliat\",\"doi\":\"10.1159/000542028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Introduction Partial hepatectomy (PH) remains associated with complication rates around 30-50%. Delayed return of gastrointestinal function (DRGF) has been reported in 10-20%. This study aimed to assess DRGF predictors after PH. Aim This retrospective study aimed to assess DRGF predictors after PH. Methods All patients who underwent PH between 01/2010 and 12/2019 were included. DRGF was defined as need of postoperative nasogastric tube (NGT). Independent DRGF predictors were identified with multivariable logistic binary regression. Results Overall, 501 patients were included. DRGF occurred in 82 patients (16%). A hundred-and-twelve patients (22%) underwent a minimally invasive approach and DRGF incidence was significantly lower in this group (p <0.001). DRGF was more frequent after major PH (p<0.001). DRGF occurred more often in patients with preoperative embolization (p<0.001), biliary anastomosis (p<0.001) and extrahepatic resection (p<0.001). Patients with DRGF had longer median operation duration (p<0.001), more biliary leaks/bilomas (p<0.001) and higher median blood loss (p<0.001). DRGF patients developed more pneumonias (p<0.001) and had longer median length of stay (p<0.001). On multivariable analysis, operation duration (p<0.001), major hepatectomy (p<0.001) and postoperative biloma/biliary leak (p<0.001) were independently associated with DRGF occurrence. Conclusion Postoperative DRGF occurred in 16% of the patients and was associated with longer length of stay. Surgery duration, major PH and postoperative biloma/biliary leak were found as independent predictors of DRGF.</p>\",\"PeriodicalId\":11241,\"journal\":{\"name\":\"Digestive Surgery\",\"volume\":\" \",\"pages\":\"1-16\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-11-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestive Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000542028\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000542028","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Delayed return of gastrointestinal function after partial hepatectomy: a single-center cross-sectional study.
Introduction Partial hepatectomy (PH) remains associated with complication rates around 30-50%. Delayed return of gastrointestinal function (DRGF) has been reported in 10-20%. This study aimed to assess DRGF predictors after PH. Aim This retrospective study aimed to assess DRGF predictors after PH. Methods All patients who underwent PH between 01/2010 and 12/2019 were included. DRGF was defined as need of postoperative nasogastric tube (NGT). Independent DRGF predictors were identified with multivariable logistic binary regression. Results Overall, 501 patients were included. DRGF occurred in 82 patients (16%). A hundred-and-twelve patients (22%) underwent a minimally invasive approach and DRGF incidence was significantly lower in this group (p <0.001). DRGF was more frequent after major PH (p<0.001). DRGF occurred more often in patients with preoperative embolization (p<0.001), biliary anastomosis (p<0.001) and extrahepatic resection (p<0.001). Patients with DRGF had longer median operation duration (p<0.001), more biliary leaks/bilomas (p<0.001) and higher median blood loss (p<0.001). DRGF patients developed more pneumonias (p<0.001) and had longer median length of stay (p<0.001). On multivariable analysis, operation duration (p<0.001), major hepatectomy (p<0.001) and postoperative biloma/biliary leak (p<0.001) were independently associated with DRGF occurrence. Conclusion Postoperative DRGF occurred in 16% of the patients and was associated with longer length of stay. Surgery duration, major PH and postoperative biloma/biliary leak were found as independent predictors of DRGF.
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.