Early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy

Tao Huang; Meiwen Yang; Leida Zhang

doi:10.16016/j.1000-5404.201612207

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Early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy

Clinical Medicine | 更新时间：2026-02-09

- Early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy
- Journal of Third Military Medical University Vol. 39, Issue 10, Pages: 1019-1024(2017)
- 作者机构：
  
  400038 重庆，第三军医大学西南医院全军肝胆外科研究所
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201612207
  CLC： R619;R657.5
- Received：29 December 2016，
  
  Revised：2017-01-08，
  
  Published：30 May 2017
- 稿件说明：
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Tao Huang, Meiwen Yang, Leida Zhang. Early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy[J]. Journal of Third Military Medical University, 2017, 39(10): 1019-1024.
DOI：

Tao Huang, Meiwen Yang, Leida Zhang. Early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy[J]. Journal of Third Military Medical University, 2017, 39(10): 1019-1024. DOI： 10.16016/j.1000-5404.201612207.

摘要

目的

探讨胰十二指肠切除手术(pancreaticoduodenectomy

PD)后早期拔除腹腔引流管能否减少术后胰瘘发生。

方法

回顾性分析西南医院肝胆外科2013年1月至2015年10月收治并依据纳入排除标准归入研究对象的305例PD手术患者的临床资料，按术后腹腔引流管拔除时间分为：A组，术后≤5 d拔除；B组，术后＞5 d拔除。比较两组患者术后并发症等发生情况，对胰瘘发生的相关因素进行单因素和多因素分析。

结果

术后胰瘘(3.1%

12.1%)、腹腔感染(9.2%

20.3%)以及总并发症(24.5%

42.0%)发生率A组均显著低于B组(

0.05)，术后住院时间也明显缩短。单因素分析示：性别(

0.05)、术前有无显性黄疸(

0.05)、胰管直径(

3 mm

≥3 mm，

0.05)、肿瘤发生部位(胰腺

胰腺外，

0.01)、腹腔引流管拔除时间(≤5 d

5 d，

0.05) 为术后胰瘘发生的影响因素；多因素Logistic回归分析示：男性、胰管直径

3 mm、胰腺外肿瘤(胆总管远端、十二指肠乳头部、胆胰壶腹部肿瘤)、腹腔引流管拔除时间

5 d为胰瘘发生的独立危险因素(

=4.424

2.369

3.874

5.028

0.05)。

结论

对于PD术后早期无胰瘘发生的患者，术后5 d内拔除腹腔引流管能够显著减少术后胰瘘、腹腔感染等并发症，延长腹腔引流管留置时间会增加术后胰瘘发生率。

Abstract

Objective

To investigate whether early removal of intra-abdominal drainage reduces the incidence of pancreatic fistula after pancreaticoduodenectomy (PD).

Methods

A total of 305 patients undergoing PD in Southwest Hospital between January 2013 and October 2015 were retrospectively analyzed. Intra-abdominal drainage was removed within 5 d following PD in 98 cases (group A) and after 5 days in 207 cases (group B). The postoperative complications were compared between the 2 groups

and the risk factors associated with pancreatic fistula were evaluated using univariate and multivariate analyses.

Results

Compared with those in group B

the patients in group A showed significantly lowered inc

idences of pancreatic fistula (3.1%

12.1%)

abdominal infections (9.2%

20.3%)

and overall complications (24.5%

42.0%) after PD (

0.05) with also shortened postoperative hospital stay. Univariate analysis identified gender (

=0.031)

preoperative clinical jaundice (

=0.035)

pancreatic duct diameter (

3 mm

≥3 mm

0.05)

tumor location (in the pancreas or not

=0.011) and the removal time of intra-abdominal drainage (within or after 5 d following PD

=0.011) as the risk factors of pancreatic fistula; logistic regression analysis revealed that a male gender (

=4.424)

a pancreatic duct diameter

3 mm (

=2.369)

tumors in the distal bile duct

duodenum or ampulla (

=3.874)

and dwelling time of intra-abdominal drainage for over 5 d following PD (

=5.028) as the independent risk factors of pancreatic fistula following PD (

0.05).

Conclusion

In patients free of pancreatic fistula early after PD

removing intra-abdominal drainage within 5 d can reduce the incidences of postoperative pancreatic fistula and abdominal infections

and a delayed removal of the drainage is strongly associated with an increased risk of pancreatic fistula.

关键词

Keywords

references

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