METHODS: Patients who underwent DP between 2016 and 2023 were retrospectively enrolled and divided into two groups according to the duration of the stapler closure: those who underwent a progressive compression for < 10 min and those for ≥ 10 min.
RESULTS: Among 155 DPs, 83 (53.5%) patients underwent pre-firing compression for < 10 min and 72 (46.5%) for ≥ 10 min. As a whole, 101 (65.1%) developed POPF. A lower incidence rate was found in case of ≥ 10 min compression (34-47.2%) compared to < 10 min compression (67- 80.7%) (p = 0.001). When only clinically relevant (CR) POPFs were considered, a prolonged pre-firing compression led to a lower rate (15-20.8%) than the < 10 min cohort (32-38.6%; p = 0.02). At the multivariate analysis, a compression time of at least 10 min was confirmed as a protective factor for both POPF (OR: 5.47, 95% CI: 2.16-13.87; p = 0.04) and CR-POPF (OR: 2.5, 95% CI: 1.19-5.45; p = 0.04) development. In case of a thick pancreatic gland, a prolonged pancreatic compression for at least 10 min was significantly associated to a lower rate of CR-POPF compared to < 10 min (p = 0.04).
CONCLUSIONS: A prolonged pre-firing pancreatic compression for at least 10 min seems to significantly reduce the risk of CR-POPF development. Moreover, significant advantages are documented in case of a thick pancreatic gland.
方法:回顾性纳入2016年至2023年接受DP的患者,并根据吻合器闭合的持续时间分为两组:接受渐进性压迫<10分钟的患者和≥10分钟的患者。
结果:在155名DP中,83例(53.5%)患者进行了<10分钟的预发压迫,72例(46.5%)进行了≥10分钟。作为一个整体,101(65.1%)发展了POPF。与<10分钟压缩(67-80.7%)相比,≥10分钟压缩(34-47.2%)的发生率较低(p=0.001)。当仅考虑临床相关(CR)POPFs时,与<10分钟的队列(32-38.6%;p=0.02)相比,延长的预发压缩率(15-20.8%)较低。在多变量分析中,至少10分钟的压缩时间被证实是POPF(OR:5.47,95%CI:2.16-13.87;p=0.04)和CR-POPF(OR:2.5,95%CI:1.19-5.45;p=0.04)发展的保护因素.如果胰腺厚,与<10min相比,延长的胰腺压迫至少10min与较低的CR-POPF发生率显著相关(p=0.04).
结论:延长预放电胰腺压迫至少10分钟似乎可显著降低CR-POPF发生的风险。此外,显着的优势被记录在一个厚的胰腺的情况下。