岭南现代临床外科2024，Vol.24Issue(6)：335-346,12.DOI:10.3969/j.issn.1009-976X.2024.06.001
胰十二指肠切除术后迟发性出血危险因素的Meta分析
Risk factors in delayed post-pancreaticoduodenectomy hemorrhage:a meta-analysis
摘要
Abstract
Objective Through meta-analysis of risk factors related to delayed post-pancreaticoduode-nectomy hemorrhage(DPPDH)at home and abroad,to provide theoretical basis for prevention and treatment of delayed hemorrhage after pancreaticoduodenectomy.Methods Previous studies on the risk factors of delayed hemorrhage after pancreaticoduodenectomy were searched by computer in medical literature databases,including PubMed,Cochrane Library,Embase,Web of science,CNKI,Wanfang,VIP and other resources.RevMan 5.4 and STATA were used in this meta-analysis.The heterogeneity and publication bias of the research is included in analysis to ensure the reliabity of this meta-analysis.Results A total of 16 retrospective studies were included.Meta-analysis showed thatthere was no significant differences between diabetes mellitus,hypertension,preoperative albumin,preoperative biliary drainage or not,tumor character,delayed gastric emptying and delayed hemorrhage after pancreaticoduo-denectomy(P>0.05).And the results showed that the elderly(SMD=0.16,95%CI:0.02-0.29,P=0.02),male(OR=1.77,95%CI:1.43-2.18,P<0.001),preoperative total bilirubin(OR=0.28,95%CI:0.04-0.51,P=0.02),vascular reconstruction(OR=1.75,95%CI:1.08-2.84,P=0.02),soft pancreas texture(OR=0.39,95%CI:0.23-0.66,P=0.0005),pancreatic duct diameter<3 mm(OR=0.53,95%CI:0.35-0.81,P=0.004),pancreatic leakage(OR=4.04,95%CI:3.19-5.13,P<0.001),bile leakage(OR=4.04,95%CI:2.83-5.76,P<0.001)and abdominal infection(OR=6.61,95%CI:4.60-9.51,P<0.001)was closely related to the occurrence of delayed hemorrhage after pancreaticoduodenectomy.Conclusion There was no significant association between the DPPDH anddiabetes mellitus,hypertension,preopera-tive albumin,preoperative biliary drainage or not,tumor character,delayed gastric emptying.Age,gen-der,preoperative total bilirubin,vascular reconstruction,pancreas texture,pancreatic duct diameter,pancreatic leakage,bile leakage,abdominal infection are factors associated with DPPDH.关键词
胰十二指肠切除/迟发性出血/危险因素/Meta分析Key words
pancreaticoduodenectomy/delayed hemorrhage/risk fctors/meta-analysis分类
医药卫生引用本文复制引用
杨光,吴建武,蒋新卫..胰十二指肠切除术后迟发性出血危险因素的Meta分析[J].岭南现代临床外科,2024,24(6):335-346,12.基金项目
苏州市肝胆外科临床医学中心项目(Szlcyxzxj202107) （Szlcyxzxj202107）
苏州市科技局医学应用基础研究项目(GSKY20210204) （GSKY20210204）
