目的探讨胰肠吻合术中胰腺断面上胰管所处位置对术后胰瘘发生的影响。方法回顾性收集2018年9月至2020年8月期间笔者所在医院胰腺外科收治的行胰十二指肠切除术患者的资料,比较术中胰腺断面与术前CT横断面图像中胰管中心到胰腺边缘距离...目的探讨胰肠吻合术中胰腺断面上胰管所处位置对术后胰瘘发生的影响。方法回顾性收集2018年9月至2020年8月期间笔者所在医院胰腺外科收治的行胰十二指肠切除术患者的资料,比较术中胰腺断面与术前CT横断面图像中胰管中心到胰腺边缘距离测定值的一致性,对术后胰瘘的发生行单因素分析和多因素logistic回归模型分析,判断胰肠吻合术中胰腺断面上胰管所处位置是否对术后胰瘘的发生造成影响。结果本研究总计纳入患者373例,选取其中44例患者于术中测量胰管中心到胰腺边缘的短距与胰腺断面处总厚度的比值为0.41±0.09,其术前影像学测量值为0.40±0.10,两种测量方法的组内相关系数(interclass correlation coefficient,ICC)检测值=0.916(>0.75),P<0.001,具有较高的一致性。患者身体质量指数(body mass index,BMI)较高[OR=1.276,95%CI为(1.154,1.411),P<0.0001]和胰腺质地软[OR=2.771,95%CI为(1.558,4.927),P=0.001]是术后胰瘘发生的独立危险因素,而随着患者胰管中心到胰腺边缘的短距与胰腺总厚度的比值增大,术后胰瘘发生的风险降低[OR=0.875,95%CI为(0.840,0.911),P<0.0001]。结论患者BMI较高和胰腺质地软是术后胰瘘发生的独立危险因素,胰管中心远离胰腺边缘时术后胰瘘发生风险降低;根据术前影像学测量的胰管中心到胰腺边缘的短距与胰腺总厚度的比值可用于评估术后胰瘘发生风险。展开更多
To present problems that might severely impact the conclusions drawn by the authors of an article on antioxidant treatment in chronic pancreatitis(World J Gastroenterol 2010;16:4066-4071).We analyzed and discussed thi...To present problems that might severely impact the conclusions drawn by the authors of an article on antioxidant treatment in chronic pancreatitis(World J Gastroenterol 2010;16:4066-4071).We analyzed and discussed this paper by Shah et al,and found that promising as it is,this study has some methodological shortcomings,such as:cross-sectional nature of the study,lack of initial evaluations of quality of life and regular follow-ups to determine the dynamics and real directions of changes in quality of life.We therefore concluded that the results of the study by Shah et al are biased and,although very promising,should not be considered as scientifically relevant.展开更多
Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pan...Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pancreatic neck from Jan. 1995 to Dec. 2000. External drainage was performed in all patients. Pancreatoduodenectomy was conducted in 2 patients with a transected injury to the pancreatic neck associated with duodenal ruptures, and TPN was administered immediately after operation. Proximal closure of the transected margin and distal pancreaticojejunostomy was performed in 4 patients. Proximal closure of the transected margin and distal pancreaticojejunostomy plus splenectomy was performed in 7 patients associated with contusion of pancreatic body or tail plus spleen rupture. Results: 12 patients healed and one patient died of anesthetic accident during the course of restoration of the dislocation of his right hip joint. Complications occurred in 7 patients.Conclusions: The operation should be performed according to the degree of the injuries and associated duodenal injuries. Routine drainage and nutrient support should be recommended.展开更多
文摘目的探讨胰肠吻合术中胰腺断面上胰管所处位置对术后胰瘘发生的影响。方法回顾性收集2018年9月至2020年8月期间笔者所在医院胰腺外科收治的行胰十二指肠切除术患者的资料,比较术中胰腺断面与术前CT横断面图像中胰管中心到胰腺边缘距离测定值的一致性,对术后胰瘘的发生行单因素分析和多因素logistic回归模型分析,判断胰肠吻合术中胰腺断面上胰管所处位置是否对术后胰瘘的发生造成影响。结果本研究总计纳入患者373例,选取其中44例患者于术中测量胰管中心到胰腺边缘的短距与胰腺断面处总厚度的比值为0.41±0.09,其术前影像学测量值为0.40±0.10,两种测量方法的组内相关系数(interclass correlation coefficient,ICC)检测值=0.916(>0.75),P<0.001,具有较高的一致性。患者身体质量指数(body mass index,BMI)较高[OR=1.276,95%CI为(1.154,1.411),P<0.0001]和胰腺质地软[OR=2.771,95%CI为(1.558,4.927),P=0.001]是术后胰瘘发生的独立危险因素,而随着患者胰管中心到胰腺边缘的短距与胰腺总厚度的比值增大,术后胰瘘发生的风险降低[OR=0.875,95%CI为(0.840,0.911),P<0.0001]。结论患者BMI较高和胰腺质地软是术后胰瘘发生的独立危险因素,胰管中心远离胰腺边缘时术后胰瘘发生风险降低;根据术前影像学测量的胰管中心到胰腺边缘的短距与胰腺总厚度的比值可用于评估术后胰瘘发生风险。
文摘To present problems that might severely impact the conclusions drawn by the authors of an article on antioxidant treatment in chronic pancreatitis(World J Gastroenterol 2010;16:4066-4071).We analyzed and discussed this paper by Shah et al,and found that promising as it is,this study has some methodological shortcomings,such as:cross-sectional nature of the study,lack of initial evaluations of quality of life and regular follow-ups to determine the dynamics and real directions of changes in quality of life.We therefore concluded that the results of the study by Shah et al are biased and,although very promising,should not be considered as scientifically relevant.
文摘Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pancreatic neck from Jan. 1995 to Dec. 2000. External drainage was performed in all patients. Pancreatoduodenectomy was conducted in 2 patients with a transected injury to the pancreatic neck associated with duodenal ruptures, and TPN was administered immediately after operation. Proximal closure of the transected margin and distal pancreaticojejunostomy was performed in 4 patients. Proximal closure of the transected margin and distal pancreaticojejunostomy plus splenectomy was performed in 7 patients associated with contusion of pancreatic body or tail plus spleen rupture. Results: 12 patients healed and one patient died of anesthetic accident during the course of restoration of the dislocation of his right hip joint. Complications occurred in 7 patients.Conclusions: The operation should be performed according to the degree of the injuries and associated duodenal injuries. Routine drainage and nutrient support should be recommended.
