지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.4
- 발행연도
- 2020.4
- 수록면
- 177 - 183 (7page)
이용수
초록· 키워드
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Purpose: Although pancreatoduodenectomy (PD) in patients who have previously undergone gastrectomy is challenging, little is known about the clinical outcomes and the differences compared to those with conventional PD. We collected cases and conducted studies in retrospective review.
Methods: Of the 1,722 patients who underwent PD at Seoul National University Hospital between 2000 and 2014, 49 (2.8%) underwent previous gastrectomy. Clinical outcomes including operation-related factors and postoperative morbidities were analyzed.
Results: Among the 49 patients with curative surgery, 25 patients were male (51.0%) and the mean age was 64.7 years. Gastric cancer was the most frequent cause of previous gastrectomy (93.8%). With one-to-one propensity score matching analysis, lower preoperative body mass index (22.6 kg/m² vs. 20.8 kg/m², P = 0.002), higher EBL (390.0 mL vs. 729.5 mL, P = 0.027), and higher transfusion rates (10.2% vs. 36.7%, P = 0.002) were shown in the gastrectomy group. Operation time, postoperative hospital stay, and rate of clinically relevant pancreatic fistula were comparable.
Conclusion: Secondary PD after prior gastrectomy remains challenging, with higher EBL and rate of transfusion. However, when performed by experienced surgeons, the patients with or without previous gastrectomy show comparable postoperative clinical outcomes, such as similar duration of postoperative hospital stay and rate of postoperative pancreatic fistula.
Methods: Of the 1,722 patients who underwent PD at Seoul National University Hospital between 2000 and 2014, 49 (2.8%) underwent previous gastrectomy. Clinical outcomes including operation-related factors and postoperative morbidities were analyzed.
Results: Among the 49 patients with curative surgery, 25 patients were male (51.0%) and the mean age was 64.7 years. Gastric cancer was the most frequent cause of previous gastrectomy (93.8%). With one-to-one propensity score matching analysis, lower preoperative body mass index (22.6 kg/m² vs. 20.8 kg/m², P = 0.002), higher EBL (390.0 mL vs. 729.5 mL, P = 0.027), and higher transfusion rates (10.2% vs. 36.7%, P = 0.002) were shown in the gastrectomy group. Operation time, postoperative hospital stay, and rate of clinically relevant pancreatic fistula were comparable.
Conclusion: Secondary PD after prior gastrectomy remains challenging, with higher EBL and rate of transfusion. However, when performed by experienced surgeons, the patients with or without previous gastrectomy show comparable postoperative clinical outcomes, such as similar duration of postoperative hospital stay and rate of postoperative pancreatic fistula.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
Whipple AO / 1946 / Observations on radical surgery for lesions of the pancreas / Surg Gynecol Obstet 82:623~631
Okano K / 2015 / Postoperative infectious complications after pancreatic resection / Br J Surg 102:1551~1560
Jang JY / 2014 / A prospective randomized controlled study comparing outcomes of standard resection and extended resection, including dissection of the nerve plexus and various lymph nodes, in patients with pancreatic head cancer / Ann Surg 259:656~664
Bassi C / 2001 / Management of complications after pancreaticoduodenectomy in a high volume centre : results on 150 consecutive patients / Dig Surg 18:453~457
Ferlay J / 2015 / Cancer incidence and mortality worldwide : sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386
Okano K / 2015 / Postoperative infectious complications after pancreatic resection / Br J Surg 102:1551~1560
Jang JY / 2014 / A prospective randomized controlled study comparing outcomes of standard resection and extended resection, including dissection of the nerve plexus and various lymph nodes, in patients with pancreatic head cancer / Ann Surg 259:656~664
Bassi C / 2001 / Management of complications after pancreaticoduodenectomy in a high volume centre : results on 150 consecutive patients / Dig Surg 18:453~457
Ferlay J / 2015 / Cancer incidence and mortality worldwide : sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386
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UCI(KEPA) : I410-ECN-0101-2020-514-000533261