梗阻性黄疸对胰十二指肠切除术术后感染并发症的影响

Preoperative obstructive jaundice and postoperative infectious complications after pancreaticoduodenectomy

目的尽管近些年有术前评估技术的不断提高和术后强效抗生素的应用,梗阻性黄疸患者行胰十二指肠切除术仍有较高的术后感染并发症率及其相关病死率。文中探究胰十二指肠切除术患者术前梗阻性黄疸程度与时间对术后感染并发症的影响。方法收集2006年1月至2010年4月择期实施的116例胰十二指肠切除术,均未行术前胆道引流,回顾性分析术前黄疸程度及时间对术后感染并发症的影响。结果中度和重度黄疸组术后感染相关并发症的发生率明显高于无黄疸组(P<0.05),长期黄疸组术后感染相关并发症的发生率显著高于无黄疸组(P<0.05),余各组间无明显差异。结论术前重度黄疸和术前黄疸时间长均可显著增加胰十二指肠切除术后感染并发症的发生率。

Objective Despite advances in preoperative evaluation and postoperative care and intervention,pancreaticoduodenectomy for obstructive jaundice still carries high rates of postoperative infectious complications and death.The aim of this study was to investigate the correlation of the degree and duration of preoperative jaundice with postoperative infectious complications in patients undergoing pancreaticoduodenectomy.Methods We included in this study 116 cases of pancreaticoduodenectomy without preoperative biliary drainage,and analyzed the effects of the intensity and duration of preoperative jaundice on postoperative infectious complications.Results Compared with the non-jaundice group,the incidence of postoperative infectious complications was significantly higher in the moderate and severe jaundice groups（P0.05） and the long-duration（10 d） jaundice group（P0.01）.ConclusionEither severe or long-duration jaundice may increase the incidence of postoperative infectious complications following pancreaticoduodenectomy.