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首页> 外文期刊>Surgical Endoscopy >Impact of anatomical position of the pancreas on postoperative complications and drain amylase concentrations after laparoscopic distal gastrectomy for gastric cancer
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Impact of anatomical position of the pancreas on postoperative complications and drain amylase concentrations after laparoscopic distal gastrectomy for gastric cancer

机译：胰腺术后腹腔镜远端胃切除术后胰腺解剖学位置对胃癌后术后并发症的影响及排水淀粉酶浓度

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摘要

Background Laparoscopic surgery for gastric cancer requires traction or compression of the pancreas, with the extent depending on the anatomical position of the pancreas. This study investigated the impact of the position of the pancreas on postoperative complications and drain amylase concentrations after laparoscopic distal gastrectomy (LDG). Methods Gastric cancer patients who underwent LDG were assessed retrospectively. The following anatomical parameters were measured retrospectively in preoperative computed tomography sagittal projections: the length of the vertical line between the pancreas and the aorta (P–A length), representing the height of the slope looking down the celiac artery from the top of the pancreas, and the angle between a line drawn from the upper border of the pancreas to the root of the celiac artery and the aorta (UP–CA angle), representing the steepness of the slope. Correlations between each parameter and postoperative complications were analyzed by logistic regression analysis. Pearson’s product–moment correlation coefficients were calculated for scatter diagrams for each parameter and drain amylase concentration on postoperative day 1. Results Analyses were performed in 394 patients. P–A length [odds ratio (OR) 1.905; 95% confidence interval (CI) 1.100–3.300; P ?=?0.021] was significantly correlated with pancreatic fistula. P–A length (OR 2.771; 95% CI 1.506–5.098; P ?=?0.001), UP–CA angle (OR 2.323; 95% CI 1.251–4.314; P ?=?0.008), and low preoperative serum albumin (OR 2.082; 95% CI 1.050–4.128; P ?=?0.036) were significantly correlated with overall postoperative complications defined as Clavien–Dindo ≥?grade II. P–A length and UP–CA angle showed significant positive correlations with drain amylase concentration on postoperative day 1. Conclusion The position of the pancreas is an independent predictor of pancreatic fistula and/or postoperative complications and correlates with drain amylase concentration after LDG for gastric cancer.
机译：背景技术胃癌腹腔镜手术需要捕获或压缩胰腺，这取决于胰腺的解剖位置。本研究调查了胰腺对腹腔镜远端胃切除术（LDG）后胰腺的位置对术后并发症和排出淀粉酶浓度的影响。方法回顾LDG的胃癌患者进行回顾性评估。回顾性地测量以下解剖学参数，在术前计算断层摄影矢状矢状突起：胰腺和主动脉（P-A长度）之间的垂直线的长度，表示从胰腺的顶部向下看腹腔动脉的斜率的高度，从胰腺的上边缘绘制到腹腔动脉的根部和主动脉（上部CA角度）的线之间的角度，代表斜坡的陡度。通过逻辑回归分析分析每个参数和术后并发症之间的相关性。 Pearson的产瞬间相关系数是针对术后第1天的每种参数和漏氨基酶浓度的散点图计算的。结果分析在394名患者中进行。 p-a长度[赔率比（或）1.905; 95％置信区间（CI）1.100-3.300; p？= 0.021]与胰瘘显着相关。 p-a长度（或2.771; 95％ci 1.506-5.098; p？= 0.001），up-ca角度（或2.323; 95％ci 1.251-4.314; p？= 0.008）和低术前血清白蛋白（或2.082; 95％CI 1.050-4.128; p？= 0.036）与定义为Clavien-Dindo≥α的整体术后并发症显着相关。 P-A长度和Up-Ca角度显示出术后第1天的漏极淀粉酶浓度的显着正相关。结论胰腺的位置是胰瘘和/或术后并发症的独立预测因子，并在LDG后与漏油淀粉酶浓度相关癌症。

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  • 来源
    《Surgical Endoscopy》 |2018年第9期|共9页
  • 作者

    Koshi Kumagai; Naoki Hiki; Souya Nunobe; Satoshi Kamiya; Masahiro Tsujiura; Satoshi Ida; Manabu Ohashi; Toshiharu Yamaguchi; Takeshi Sano;

  • 作者单位

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

    Department of Gastroenterological Surgery Cancer Institute Hospital Japanese Foundation for;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Stomach; Cancer; Pancreas; Complication; Anatomical position;

    机译：胃;癌症;胰腺;并发症;解剖位置;

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