冲-引分体引流管在胰腺术后预防并发症的临床疗效OA北大核心CSTPCD

Background and Aims:Postoperative complications are important factors affecting the prognosis of patients undergoing pancreatic surgery.An abdominal drainage tube placement is a routine procedure to reduce postoperative complications.Currently,there are various types of drainage tubes with significant differences in efficacy.This study was to introduce a method of using a self-made douching-draining separate drainage tube and explore its clinical application effects. Methods:The clinical data of 213 patients who underwent pancreaticoduodenectomy(PD)or distal pancreatectomy(DP)performed by the author's team from the Department of Hepatopancreatobiliary and Splenic Surgery,the First Affiliated Hospital of Naval Medical University from January 1,2021 to July 1,2023 were retrospectively analyzed.All patients were treated with the self-made douching-draining separate drainage tube.The proportion of textbook outcome(TO)achieved in both procedures,the incidence rates of postoperative specific complications and severe complications(Clavien-Dindo complications classification grade≥Ⅲ),postoperative hospital stay,30-d readmission rate,and 30-d and 90-d mortality rates were statistically analyzed and compared with relevant literature. Results:Among the 213 patients,143 underwent PD,and 70 underwent DP,with TO rates of 69.2%(99/143)and 81.4%(57/70),respectively.The 30-d and 90-d mortality rates for PD patients were 0.7%(1/143),while for DP patients,both were 0(0/70).The incidence of pancreatic fistula(grade B/C)in PD and DP patients was 9.8%(14/143)and 8.6%(6/70),respectively,bile leakage(grade B/C)occurred in 4.2%(6/143)and 0(0/70),postoperative hemorrhage(grade B/C)occurred in 6.3%(9/143)and 0(0/70),gastric emptying disorder(grade B/C)occurred in 7.7%(11/143)and 2.9%(2/70),and the incidence of severe complications was 18.2%(26/143)and 7.1%(5/70),respectively.The postoperative hospital stays were 11(9-14)d and 7(6-10)d for PD and DP patients,respectively,and the 30-d readmission rates were 9.8%(14/143)and 7.1%(5/70),respectively.Compared with relevant literature,the TO rate of patients in this group was higher,with decreased 30-d and 90-d mortality rates,decreased incidence of postoperative pancreatic fistula,bile leakage,postoperative hemorrhage,gastric emptying disorder,severe complications,and 30-d readmission rates. Conclusion:Using a self-made douching-draining separate drainage tube after pancreatic surgery can relatively increase the TO rate,effectively reduce perioperative mortality and the incidence of related complications and severe complications,as well as the 30-d readmission rate,thereby improving the perioperative safety of patients.It has a positive significance for postoperative recovery and patient prognosis.