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Wu, Yi; Wujimaimaiti, Nuerabula; Yuan, Jingxiong; Li, Shizhen; Zhang, Hang; Wang, Min; Qin, Renyi

Risk factors for achieving textbook outcome after laparoscopic duodenum-preserving total pancreatic head resection: a retrospective cohort study

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  • Medientyp: E-Artikel
  • Titel: Risk factors for achieving textbook outcome after laparoscopic duodenum-preserving total pancreatic head resection: a retrospective cohort study
  • Beteiligte: Wu, Yi; Wujimaimaiti, Nuerabula; Yuan, Jingxiong; Li, Shizhen; Zhang, Hang; Wang, Min; Qin, Renyi
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2023
  • Erschienen in: International Journal of Surgery
  • Sprache: Englisch
  • DOI: 10.1097/js9.0000000000000251
  • ISSN: 1743-9159
  • Schlagwörter: General Medicine ; Surgery
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Introduction:</jats:title> <jats:p>The risk factors for achieving textbook outcome (TO) after laparoscopic duodenum-preserving total pancreatic head resection (LDPPHR-t) are unknown, and no relevant articles have been reported so far. The aim of this study was to identify the risk factors for achieving TO after LDPPHR-t.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>The risk factors for achieving TO after LDPPHR-t were retrospectively evaluated by logistic regression analysis in 31 consecutive patients from May 2020 to December 2021.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>All LDPPHR-t procedures were successfully performed without conversion. There was no death within 90 days after surgery and no readmission within 30 days after discharge. The percentage of achieving TO after LDPPHR-t was 61.3% (19/31). Among the six TO items, the postoperative complication of grade B/C postoperative pancreatic fistula (POPF) occurred most frequently with 22.6%, followed by grade B/C bile leakage with 19.4%, Clavien–Dindo≥III complications with 19.4%, and grade B/C postpancreatectomy hemorrhage with 16.1%. POPF was the major obstacle to achieve TO after LDPPHR-t. Placing an endoscopic nasobiliary drainage (ENBD) catheter and prolonged operation time (&gt;311 min) were significantly associated with the decreased probability of achieving TO after LDPPHR-t (odd ratio (OR), 25.775; <jats:italic toggle="yes">P</jats:italic>=0.012 and OR, 16.378; <jats:italic toggle="yes">P</jats:italic>=0.020, respectively). Placing an ENBD catheter was the only significant independent risk factor for POPF after LDPPHR-t (OR, 19.580; <jats:italic toggle="yes">P</jats:italic>=0.017). Bile leakage was the independent risk factor for postpancreatectomy hemorrhage after LDPPHR-t (OR, 15.754; <jats:italic toggle="yes">P</jats:italic>=0.040). The prolonged operation time was significantly correlated with Clavien–Dindo grade≥III complications after LDPPHR-t (OR, 19.126; <jats:italic toggle="yes">P</jats:italic>=0.024).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>Placing the ENBD catheter was the independent risk factor for POPF and achieving TO after LDPPHR-t. In order to reduce POPF and increase the probability of achieving TO, placing an ENBD catheter should be avoided prior to LDPPHR-t.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang