胰腺切除术后发病率的改变.pdfVIP

ORIGINAL ARTICLE Changes in Morbidity After Pancreatic Resection Toward the End of Completion Pancreatectomy Markus W. Bu¨chler, MD; Markus Wagner, MD; Bruno M. Schmied, MD; Waldemar Uhl, MD; Helmut Friess, MD; Kaspar Z’graggen, MD Hypothesis: Advances in specialized centers for pan- Main Outcome Measures: Morbidity after pancre- creatic diseases have improved surgical morbidity and out- atic resection. come. In the past, postoperative local complications (pan- creatic fistulae) were causing most of the mortality. Now, Results: Postoperative in-hospital mortality was 1.6%, more patients experience postoperative complications re- and the additional operation rate was 4.1%. Four pa- lated to their comorbidity. tients died of surgical complications and 6 of systemic complications. Systemic morbidity was 18% and con- sisted primarily of cardiopulmonary complications (13%). Design: To report a prospective audit of a single cen- The most frequent postoperative complication was de- ter’s experience with pancreatic resection during an 8-year layed gastric emptying (14%), which caused significant period. prolongation of the hospital stay. No patients died of a postoperative pancreatic fistula, which occurred in 3.2%, Setting: Tertiary referral center focused on pancreatic and no completion pancreatectomies were necessary. diseases. Conclusions: Pancreaticresectionscanbeperformedwith