背景:腹腔镜胰腺切除术(LRP)已在不同程度上实施,因为它在技术上要求很高,并且需要很长的学习曲线。在本研究中,我们在105个连续LRP的单中心研究中分析了并发症和再入院的危险因素。
方法:我们使用前瞻性数据库进行了一项回顾性研究。数据收集了年龄,性别,BMI,ASA得分,手术类型,组织学类型,手术时间,住院,术后并发症,严重程度和再次入院。
结果:该队列包括105名患者,63名女性和42名男性,中位年龄和BMI分别为58(53-70)和25.5(22,2-27.9)。18例(17%)中央胰腺切除术,5次(4.8%)摘除,进行了81例(77.6%)远端胰腺切除术和1例全胰腺切除术。56例患者(53.3%)出现某种类型的并发症,其中13例(12.3%)为重度(Clavien-Dindo>IIIb),11例(10.5%)患者在术后前30天再次入院.在单变量分析中,年龄,男性,ASA得分,胰腺中央切除术和手术时间与并发症的发生有关(P<0.05)。在多变量分析中,男性(OR7.97;95%CI1.08-58.88),严重并发症(OR59.40;95%CI,7.69-458.99),腹内收集物的发展(OR8.97;95%CI,1.28-63.02)与再入院相关.
结论:年龄,男性,ASA得分,手术时间和中央胰腺切除术的并发症发生率较高。男性,严重的并发症和腹腔内聚集与更多的再入院相关.
BACKGROUND: Laparoscopic resection of the pancreas (LRP) has been implemented to a varying degree because it is technically demanding and requires a long learning curve. In the present study we analyze the risk factors for complications and hospital readmissions in a single center study of 105 consecutive LRPs.
METHODS: We conducted a retrospective study using a prospective database. Data were collected on age, gender, BMI, ASA score, type of surgery, histologic type, operative time, hospital stay, postoperative complications, degree of severity and hospital readmission.
RESULTS: The cohort included 105 patients, 63 females and 42 males with a median age and BMI of 58 (53-70) and 25.5 (22,2-27.9) respectively. Eighteen (17%) central pancreatectomies, 5 (4.8%) enucleations, 81 (77.6%) distal pancreatectomies and one total pancreatectomy were performed. Fifty-six patients (53.3%) experienced some type of complication, of which 13 (12.3%) were severe (Clavien-Dindo > IIIb) and 11 (10.5%) patients were readmitted in the first 30 days after surgery. In the univariate analysis, age, male gender, ASA score, central pancreatectomy and operative time were significantly associated with the development of complications (P <0.05). In the multivariate analysis, male gender (OR 7.97; 95% CI 1.08-58.88)), severe complications (OR 59.40; 95% CI, 7.69-458.99), and the development of intrabdominal collections (OR 8.97; 95% CI, 1.28-63.02)) were associated with hospital readmission.
CONCLUSIONS: Age, male gender, ASA score, operative time and central pancreatectomy are associated with a higher incidence of complications. Male gender, severe complications and intraabdominal collections are associated with more hospital readmissions.