胰十二指肠切除术后胃瘫的危险因素分析

Risk Factors of Gastric Paralysis Following Pancreaticoduodenectomy

目的分析胰十二指肠切除术后影响胃瘫发生的危险因素,为预防及治疗胃瘫提供帮助。方法通过查阅并筛选国内外相关文献,归纳总结有关胃瘫的诊断标准、危险因素及最新进展。结果胃瘫是胰十二指肠切除术后最常见的并发症之一,其发生可能由多种危险因素共同造成,如手术方式、胃肠道吻合方式、腹腔并发症、长期高血糖、术后大量补液等。结论国际胰腺外科学组对胃瘫的定义应用广泛,但是其没有办法区分胃瘫是原发性还是由其他并发症引起,因此这种定义标准很可能高估胃瘫的发生率;引起胃瘫发生的危险因素目前仍存在一定争议,各中心的研究结果并不完全一致,还需要更多的前瞻性随机对照试验进一步研究。

Objective To analyze risk factors of gastric paralysis following pancreaticoduodenectomy so as to offer help for prevention and treatment of gastric paralysis. Method Domestic and international literatures about gastric paralysis following pancreaticoduodenectomy were collected, diagnostic criteria, risk factors, and the latest progress ofgastric paralysis were summarized. Results Gastric paralysis is one of the most common postoperative complications following pancreaticoduodenectomy. It might be caused by many risk factors, such as operation method, gastrointestinal anastomosis, abdominal complications, chronic hyperglycemia, and excess infusion, etc. Conclusions Although definition of gastric paralysis by ISGPS is widely adopted, it fails to distinguish gastric paralysis from impaired gastric function related to other postoperative complications and it might result in an overestimation of its true morbidity. The risk factors of occurrence of gastric paralysis are still in controversy and results of research in different centers are not same, more prospective randomized controlled trials are needed.