中国普通外科杂志2025，Vol.34Issue(9)：1934-1945,12.DOI:10.7659/j.issn.1005-6947.250118
术中鼻空肠管置入与腹腔镜胰十二指肠切除术后胃排空延迟的相关性分析
Association between intraoperative nasojejunal tube placement and delayed gastric emptying after laparoscopic pancreaticoduodenectomy
摘要
Abstract
Background and Aims:Laparoscopic pancreaticoduodenectomy(LPD)has become a preferred approach for periampullary tumors,yet delayed gastric emptying(DGE)remains a frequent complication that hampers postoperative recovery.The nasojejunal feeding tube(NJT)is commonly used for early enteral nutrition,but its impact on DGE is controversial.This study aimed to evaluate whether intraoperative NJT placement increases the risk of DGE after LPD and to assess its influence on postoperative recovery outcomes. Methods:A retrospective cohort of 319 patients who underwent LPD at Provincial Hospital Affiliated to Shandong First Medical University from April 2017 to November 2023 was analyzed.Patients were divided into two groups based on intraoperative NJT placement(NJT group,n=200;non-NJT group,n=119).The incidence of DGE and postoperative outcomes were compared.Multivariate logistic regression and propensity score matching(PSM)were performed to identify independent risk factors for DGE. Results:The incidence of grade B/C DGE was significantly higher in the NJT group than in the non-NJT group(36.5%vs.21.8%,P=0.006).NJT placement was associated with longer postoperative hospital stay and higher hospitalization costs(both P<0.05).Multivariate analysis revealed intraoperative NJT placement(OR=1.960,95%CI=1.142-3.363,P=0.015)and intraoperative blood loss>400 mL(OR=1.921,95%CI=1.155-3.194,P=0.012)as independent risk factors for DGE.These findings were consistent after PSM. Conclusions:Prophylactic intraoperative NJT placement confers no additional benefit for postoperative recovery after LPD and is associated with a higher risk of DGE,prolonged hospitalization,and increased medical costs.Routine NJT placement should therefore be avoided,and individualized strategies should be adopted to minimize postoperative complications and enhance recovery.关键词
胰十二指肠切除术/腹腔镜/肠道营养/胃排空/手术后并发症Key words
Pancreaticoduodenectomy/Laparoscopes/Enteral Nutrition/Gastric Emptying/Postoperative Complications分类
临床医学引用本文复制引用
刘勐,卢俊,周旭,王恒,孔晓晗,杨发基,牛哲禹,郝以杰,王新,朱化强,高恒军..术中鼻空肠管置入与腹腔镜胰十二指肠切除术后胃排空延迟的相关性分析[J].中国普通外科杂志,2025,34(9):1934-1945,12.基金项目
山东省自然科学基金资助项目(ZR2020MH259). （ZR2020MH259）
