Objective:To evaluate the correlation between the incidence of delayed gastric emptying(DGE)in pancreaticoduodenectomy(PD)and the perioperative possible risk factors.Methods:We searched PubMed,Embase,Cochrane Library,...Objective:To evaluate the correlation between the incidence of delayed gastric emptying(DGE)in pancreaticoduodenectomy(PD)and the perioperative possible risk factors.Methods:We searched PubMed,Embase,Cochrane Library,and Medline for studies describing complications related to PD from 2018 to 2022.Statistical analysis was performed using Stata/SE16.0 software.Results:In 6 retrospective studies,1 systematic review,and 1 randomized controlled trial(RCT)experiment,12,419 patients(2174 and 10,245 patients,respectively,in DGE and no delayed gastric emptying[NDGE]groups).The preoperative American Society of Anesthesiologists(ASA)score between DGE and NDGE groups(log odds ratio[OR]=0.23,95%credible interval[CI]:0.11-0.35,P<.01),operation time(mean diff.=21.87,95%CI:15.96-27.78,P<.01),estimated intraoperative blood loss(EIBL;mean diff.=70.67,95%CI:17.75-123.58,P<.05),postoperative pancreatic fistula(POPF)(log OR=0.85,95%CI:0.24-1.46,P<.05)were statistically significant.No significant differences in preoperative body mass index(BMI),preoperative biliary drain-age,and pancreatic texture were observed(P>.05).Conclusion:The incidence of DGE is significantly correlated with the operation time,preoperative ASA score,POPF,and EIBL,which suggests that the surgeon should thoroughly evaluate the patient through adequate preoperative examination before the operation.Finally,standardized practice and perfect technology are undoubtedly necessary to reduce complications.展开更多
Gastrointestinal bleeding(GIB)as the initial symptom is rare in patients with pancreatic cancer,which is prone to misdiagnosis and should be paid attention to by clinicians.Here,we present a patient with pancreatic he...Gastrointestinal bleeding(GIB)as the initial symptom is rare in patients with pancreatic cancer,which is prone to misdiagnosis and should be paid attention to by clinicians.Here,we present a patient with pancreatic head cancer whose first symptom was only severe upper gastrointestinal bleeding,which initially led to misdiagnosis.However,subsequent imaging revealed a mass in the pancreatic head which was considered a malignant tumor.After surgical resection,the pathology confirmed that the mass in the pancreatic head was pancreatic ductal adenocarcinoma,and the duodenal bulb’s full thickness was infiltrated.A literature review found that pancreatic cancer can present gastrointestinal bleeding by invading the digestive tract and blood vessels,left-sided portal hypertension(LSPH),digestive tract metastasis,and canceration of ectopic pancreatic tissue in the digestive tract.For these cases,clinicians should utilize multidisciplinary diagnosis and treatment based on digestive endoscopy,imaging,interventional therapy,and surgery to control bleeding,identify etiology,and remove tumors.展开更多
文摘Objective:To evaluate the correlation between the incidence of delayed gastric emptying(DGE)in pancreaticoduodenectomy(PD)and the perioperative possible risk factors.Methods:We searched PubMed,Embase,Cochrane Library,and Medline for studies describing complications related to PD from 2018 to 2022.Statistical analysis was performed using Stata/SE16.0 software.Results:In 6 retrospective studies,1 systematic review,and 1 randomized controlled trial(RCT)experiment,12,419 patients(2174 and 10,245 patients,respectively,in DGE and no delayed gastric emptying[NDGE]groups).The preoperative American Society of Anesthesiologists(ASA)score between DGE and NDGE groups(log odds ratio[OR]=0.23,95%credible interval[CI]:0.11-0.35,P<.01),operation time(mean diff.=21.87,95%CI:15.96-27.78,P<.01),estimated intraoperative blood loss(EIBL;mean diff.=70.67,95%CI:17.75-123.58,P<.05),postoperative pancreatic fistula(POPF)(log OR=0.85,95%CI:0.24-1.46,P<.05)were statistically significant.No significant differences in preoperative body mass index(BMI),preoperative biliary drain-age,and pancreatic texture were observed(P>.05).Conclusion:The incidence of DGE is significantly correlated with the operation time,preoperative ASA score,POPF,and EIBL,which suggests that the surgeon should thoroughly evaluate the patient through adequate preoperative examination before the operation.Finally,standardized practice and perfect technology are undoubtedly necessary to reduce complications.
文摘Gastrointestinal bleeding(GIB)as the initial symptom is rare in patients with pancreatic cancer,which is prone to misdiagnosis and should be paid attention to by clinicians.Here,we present a patient with pancreatic head cancer whose first symptom was only severe upper gastrointestinal bleeding,which initially led to misdiagnosis.However,subsequent imaging revealed a mass in the pancreatic head which was considered a malignant tumor.After surgical resection,the pathology confirmed that the mass in the pancreatic head was pancreatic ductal adenocarcinoma,and the duodenal bulb’s full thickness was infiltrated.A literature review found that pancreatic cancer can present gastrointestinal bleeding by invading the digestive tract and blood vessels,left-sided portal hypertension(LSPH),digestive tract metastasis,and canceration of ectopic pancreatic tissue in the digestive tract.For these cases,clinicians should utilize multidisciplinary diagnosis and treatment based on digestive endoscopy,imaging,interventional therapy,and surgery to control bleeding,identify etiology,and remove tumors.
