中华肝脏外科手术学电子杂志2016，Vol.5Issue(3)：186-189,4.DOI:10.3877/cma.j.issn.2095-3232.2016.03.014
单中心胰十二指肠切除术围手术期疗效20年变化分析
Perioperative curative effect of pancreaticoduodenectomy：a single-center analysis over two decades
摘要
Abstract
ObjectiveTo analyze the perioperative curative effect of pancreaticoduodenectomy (PD) in a single center over two decades.MethodsClinical data of 523 patients who had complete medical record and underwent PD in Sun Yat-sen Memorial Hospital, Sun Yat-sen University between January 1994 and December 2013 were retrospectively analyzed. The patients were divided into the latter decade group and the former decade group according to the year when surgery was performed. Among the 396 patients in the latter decade group, 246 were males and 150 were females with the age ranging from 19 to 97 years old and the median of 58 years old. Among the 127 patients in the former decade group, 69 were males and 58 were females with the age ranging from 6 to 79 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The perioperative conditions of two groups were compared and analyzed using rank sum test and the comparison of rate was conducted using Chi-squaretest.ResultsThe median length of surgery in the latter decade group was 340(187-920) min, significantly longer than 310(180-730) min in the former decade group (Z=3.12, P<0.05). The intraoperative blood loss in the latter decade group was 300(50-4 500) ml, significantly less than 600(200-18 000) ml in the former decade group (Z=-7.62,P<0.05). The postoperative length of stay in the latter decade group was 23(5-148) d, signiifcantly shorter than 25(11-309) d in the former decade group (Z=-2.82,P<0.05). The perioperative mortality in the latter decade group was 6% (24/396), significantly lower than 12%(15/127) in the former decade group (χ2=4.61,P<0.05). The incidence of postoperative complications and the reoperation rate of the patients with postoperative complications in the latter decade group were respectively 39% (156/396) and 29%(45/156), while those in the former decade group were respectively 46% (58/127) and 16% (9/58). The reoperation rate in the latter decade group was signiifcantly higher than that in the former decade group (χ2=3.98,P<0.05). The most common reason for reoperation was intra-abdominal hemorrhage.ConclusionsPD has become a safe and effective operation as the intraoperative blood loss, the postoperative length of stay and the perioperative mortality decrease. Timely reoperation may has an important signiifcance in reducing the perioperative mortality when severe postoperative complications happen.关键词
胰十二指肠切除术/手术后并发症/死亡率/再手术Key words
Pancreaticoduodenectomy/Postoperative complications/Mortality/Reoperation引用本文复制引用
吴祥,曾柏强,陈洁盈,张红卫..单中心胰十二指肠切除术围手术期疗效20年变化分析[J].中华肝脏外科手术学电子杂志,2016,5(3):186-189,4.基金项目
北京市希思科临床肿瘤学研究基金 （）
