胃十二指肠动脉残端保护技术在腹腔镜胰十二指肠切除术中的临床价值

Clinical value of gastroduodenal artery‑stump protection technology in laparoscopic pancrea-ticoduodenectomy

  • 摘要:
    目的 探讨胃十二指肠动脉残端保护技术(GDAPT)在腹腔镜胰十二指肠切除术(LPD)中的临床价值。
    方法 采用回顾性队列研究方法。收集2021年10月至2024年5月河北医科大学第二医院收治的288例行LPD患者的临床资料;男172例,女116例;年龄为(60±7)岁。288例LPD患者中,186例采用GDAPT,设为干预组,其中78例采用肝圆韧带GDAPT,108例采用肝左外叶和尾状叶包埋GDAPT;102例未采用GDAPT,设为对照组。观察指标:(1)手术情况。(2)术后并发症及预后情况。正态分布的计量资料组间比较采用独立样本t检验;偏态分布的计量资料组间比较采用Mann⁃Whitney U检验。计数资料组间比较采用χ²检验。
    结果 (1)手术情况。288例患者均顺利完成LPD。两组患者手术时间、术中出血量、术中输血比较,差异均无统计学意义(P>0.05)。(2)术后并发症及预后情况。干预组和对照组患者术后出血分别为7例和14例,术后住院时间分别为15.0(14.0,18.0)d和17.5(15.0,19.0)d,术后30 d内死亡患者分别为2例和7例,两组患者上述指标比较,差异均有统计学意义(χ²=9.67,Z=-2.79,χ²=5.50,P<0.05)。
    结论 与未采用GDAPT比较,LPD中应用GDAPT,未增加手术风险,且明显降低术后出血率及病死率,缩短术后住院时间。

     

    Abstract:
    Objective To investigate the clinical value of gastroduodenal artery‑stump pro-tection technology (GDAPT) in laparoscopic pancreaticoduodenectomy (LPD).
    Methods The retro-spective cohort study was conducted. The clinical data of 288 patients who underwent LPD in The Second Hospital of Hebei Medical University from October 2021 to May 2024 were collected. There were 172 males and 116 females, aged (60±7)years. Of the 288 patients, 186 patients undergoing LPD with GDAPT were divided into the intervention group, including 78 cases with GDAPT using ligamentum teres hepatis and 108 cases with GDAPT using left‑lateral lobe and hepatic caudate lobe, 102 patients undergoing LPD without GDAPT were divided into the control group. Observation indicators: (1) surgical situations; (2) postoperative complications and prognosis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann‑Whitney U test. Comparison of count data between groups was conducted using the chi-square test.
    Results (1) Surgical situations. All 288 patients completed LPD successfully. There was no significant differences in operation time, the volume of intraoperative blood loss and intraoperative blood transfusion between the two groups (P>0.05). (2) Postoperative complications and prognosis. Cases with postoperative hemorrhage, duration of postoperative hospital stay, cases dead during postoperative 30 days were 7 in the control group, 15.0(14.0,18.0) days, 2 in the intervention group, respectively, versus 14, 17.5(15.0,19.0)days, 7 in the control group, respectively, showing significant differences between the two groups (χ²=9.67, Z=-2.79, χ²=5.50, P<0.05).
    Conclusion Compared with no GDAPT, application of GDAPT in LPD can significantly reduce the postoperative hemorrhage rate, mortality and shorten the postoperative hospital stay without increasing the surgical risk.

     

/

返回文章
返回