Abstract：
OBJECTIVE: Mesopancreas resection is a crucial but difficult procedure when performing pancreaticoduodenectomy. This study evaluated the influence of mesopancreas thickness on surgical outcomes in patients undergoing pancreaticoduodenectomy.
METHODS: We measured the thickness of the fat tissue on the right side of the superior mesenteric artery from the dorsal margin of the confluence of the superior mesenteric vein and portal vein to the ventral margin of the left renal vein on preoperative contrast-enhanced computed tomography and defined it as the mesopancreas thickness. We evaluated the correlation between mesopancreas thickness and intraoperative and postoperative variables in 357 patients who underwent pancreaticoduodenectomy.
RESULTS: Multivariate analysis revealed that a thick mesopancreas was significantly associated with a long operative time (β = 10.361; 95% confidence interval, 0.370-20.353, p = 0.042), high estimated blood loss (β = 36.038; 95% confidence interval, -27.192-99.268, p = 0.013), and a low number of resected lymph nodes (β = -1.551; 95% confidence interval, -2.662--0.439, p = 0.006). This analysis further revealed that thick mesopancreas was a significant risk factor for overall morbidity (odds ratio 2.170; 95% confidence interval 1.340-3.520, p = 0.002), major morbidity (odds ratio 2.430; 95% confidence interval 1.360-4.340, p = 0.003), and a longer hospital stay (β = 2.386; 95% confidence interval 0.299-4.474, p = 0.025).
CONCLUSIONS: A thick mesopancreas could predict a longer operation time, higher estimated blood loss, fewer resected lymph nodes, more frequent overall and major morbidities, and a longer hospital stay in patients who underwent pancreaticoduodenectomy more precisely than the body mass index.
METHODS: We measured the thickness of the fat tissue on the right side of the superior mesenteric artery from the dorsal margin of the confluence of the superior mesenteric vein and portal vein to the ventral margin of the left renal vein on preoperative contrast-enhanced computed tomography and defined it as the mesopancreas thickness. We evaluated the correlation between mesopancreas thickness and intraoperative and postoperative variables in 357 patients who underwent pancreaticoduodenectomy.
RESULTS: Multivariate analysis revealed that a thick mesopancreas was significantly associated with a long operative time (β = 10.361; 95% confidence interval, 0.370-20.353, p = 0.042), high estimated blood loss (β = 36.038; 95% confidence interval, -27.192-99.268, p = 0.013), and a low number of resected lymph nodes (β = -1.551; 95% confidence interval, -2.662--0.439, p = 0.006). This analysis further revealed that thick mesopancreas was a significant risk factor for overall morbidity (odds ratio 2.170; 95% confidence interval 1.340-3.520, p = 0.002), major morbidity (odds ratio 2.430; 95% confidence interval 1.360-4.340, p = 0.003), and a longer hospital stay (β = 2.386; 95% confidence interval 0.299-4.474, p = 0.025).
CONCLUSIONS: A thick mesopancreas could predict a longer operation time, higher estimated blood loss, fewer resected lymph nodes, more frequent overall and major morbidities, and a longer hospital stay in patients who underwent pancreaticoduodenectomy more precisely than the body mass index.
摘要：
目的：在进行胰十二指肠切除术时，中胰腺切除术是一项关键但困难的手术。这项研究评估了胰十二指肠切除术患者中胰腺厚度对手术结果的影响。
方法：我们在术前对比增强计算机断层扫描中测量了肠系膜上动脉右侧从肠系膜上静脉和门静脉汇合处的背侧边缘到左肾静脉的腹侧边缘的脂肪组织厚度，并将其定义为系膜胰腺厚度。我们评估了357例接受胰十二指肠切除术的患者的中胰腺厚度与术中和术后变量之间的相关性。
结果：多变量分析显示，厚的中胰腺与手术时间长显著相关（β=10.361；95%置信区间，0.370-20.353，p=0.042），高估计失血量(β=36.038；95%置信区间，-27.192-99.268，p=0.013），切除的淋巴结数量少(β=-1.551；95%置信区间，-2.662--0.439，p=0.006）。该分析进一步表明，厚厚的中胰腺是总体发病率的重要危险因素（比值比2.170；95％置信区间1.340-3.520，p=0.002），主要发病率(比值比2.430；95%置信区间1.360-4.340，p=0.003)，住院时间较长（β=2.386；95%置信区间0.299-4.474，p=0.025）。
结论：厚胰腺可以预测更长的手术时间，更高的估计失血量，切除的淋巴结较少，更频繁的整体和重大疾病，与体重指数相比，接受胰十二指肠切除术的患者的住院时间更长。
方法：我们在术前对比增强计算机断层扫描中测量了肠系膜上动脉右侧从肠系膜上静脉和门静脉汇合处的背侧边缘到左肾静脉的腹侧边缘的脂肪组织厚度，并将其定义为系膜胰腺厚度。我们评估了357例接受胰十二指肠切除术的患者的中胰腺厚度与术中和术后变量之间的相关性。
结果：多变量分析显示，厚的中胰腺与手术时间长显著相关（β=10.361；95%置信区间，0.370-20.353，p=0.042），高估计失血量(β=36.038；95%置信区间，-27.192-99.268，p=0.013），切除的淋巴结数量少(β=-1.551；95%置信区间，-2.662--0.439，p=0.006）。该分析进一步表明，厚厚的中胰腺是总体发病率的重要危险因素（比值比2.170；95％置信区间1.340-3.520，p=0.002），主要发病率(比值比2.430；95%置信区间1.360-4.340，p=0.003)，住院时间较长（β=2.386；95%置信区间0.299-4.474，p=0.025）。
结论：厚胰腺可以预测更长的手术时间，更高的估计失血量，切除的淋巴结较少，更频繁的整体和重大疾病，与体重指数相比，接受胰十二指肠切除术的患者的住院时间更长。
