未经批准:尽管外科手术技术有了进步,术后胰瘘(POPF)仍然是胰十二指肠切除术(PD)的潜在危及生命的并发症.还提出了不吻合的胰管闭塞(PDO),以减轻PD后某些患者POPF的临床后果。
UNASSIGNED:评估患有萎缩性胰体尾和小胰管的患者在PD后机械闭合PDO的安全性和有效性。
UNASSIGNED:我们在2019年4月至2020年10月期间通过腹部术前计算机断层扫描回顾性识别了两名女性和两名男性患者。其中,3例患者在PD后接受机械闭合的PDO,其中一人在保留幽门的PD后接受了PDO。此外,对患者病历和中长期随访数据进行分析.
未经证实:术后组织学检查发现两名患者实性假乳头状瘤,一名患者的胰腺导管腺癌,1例慢性胰腺炎合并胰管结石。然而,没有患者出现生化或临床相关的POPF,没有胰腺切除术后出血,胆漏,胃排空延迟,腹内脓肿,或乳糜渗漏。在四名患者中,三个新发糖尿病,其中一人糖耐量受损。此外,三名患者接受了90,000Ph剂量的胰腺酶补充剂。欧尔.单位/d,和一个规定了更高的剂量120,000Ph.欧尔.单位/d。
UNASSIGNED:机械闭合的PDO是PD后胰腺体尾萎缩性和小胰管患者的替代方法。因此,进一步的证据应评估选择性PDO在这些患者中的潜在益处.
UNASSIGNED: Despite the advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains a potentially life-threatening complication of pancreaticoduodenectomy (PD). Pancreatic duct occlusion (PDO) without anastomosis has also been proposed to alleviate the clinical consequences of POPF in selected patients after PD.
UNASSIGNED: To assess the safety and effectiveness of PDO with mechanical closure after PD in patients with an atrophic pancreatic body-tail and a small pancreatic duct.
UNASSIGNED: We retrospectively identified two female and two male patients from April 2019 to October 2020 through preoperative computed tomography of the abdomen. Among them, three patients underwent PDO with mechanical closure after PD, and one underwent PDO after pylorus-preserving PD. In addition, patients\' medical records and medium-and long-term follow-up data were analyzed.
UNASSIGNED: Postoperative histological examination revealed a solid pseudopapillary tumor in two patients, pancreatic ductal adenocarcinoma in one patient, and chronic pancreatitis with pancreatic duct stones in one patient. However, none of the patients developed biochemical or clinically relevant POPF, with no postpancreatectomy hemorrhage, biliary leakage, delayed gastric emptying, intra-abdominal abscess, or chyle leakage. Among the four patients, three developed new-onset diabetes mellitus, and one had impaired glucose tolerance. Furthermore, three patients received pancreatic enzyme supplementation at a dose of 90,000 Ph. Eur. units/d, and one was prescribed a higher dose of 120,000 Ph. Eur. units/d.
UNASSIGNED: PDO with mechanical closure is an alternative approach for patients with an atrophic pancreatic body-tail and a small pancreatic duct after PD. Therefore, further evidence should evaluate the potential benefits of selective PDO in these patients.