地尔硫(艹卓)在控制老年术后快速心律失常中的应用

目的 :观察静脉应用地尔硫芏卓 控制老年术后快速心律失常的疗效及其安全性。方法 :6 8例老年术后快速心律失常患者被随机等分为地尔硫芏卓 组和毛花甙丙组 ,观察用药后心室率和血压的变化。结果 :地尔硫芏卓 组对控制老年术后快速心律失常有效率 94 .6 % ,毛花甙丙组有效率73.7% ,P <0 .0 1,地尔硫芏卓 组最大效应时间为 7.5± 2 .6min ,毛花甙丙组为 31.8± 7.8min。两组均无心功能恶化或低血压出现。结论 :地尔硫芏卓 能有效、安全控制老年术后快速心室率     

地尔硫卓干预冠心病患者PCI术后再狭窄的疗效

目的探讨地尔硫卓对冠心病经皮冠状动脉介入治疗(PCI)术后再狭窄的影响。方法选择冠心病PCI术后患者93例为研究对象,将其随机分为治疗组和对照组,治疗组患者在常规治疗措施的基础上给予地尔硫卓;对照组患者术后仅采用常规治疗,随访半年,观察两组再狭窄率。结果 6个月复查时对照组再狭窄率为14.58%,治疗组为2.22%,再狭窄率差异有统计学意义(P<0.05)。结论 PCI术后在常规治疗基础上加用地尔硫卓可显著降低再狭窄率及心脏不良事件发生率。     

控制快速房性心律失常心室率即时疗效临床用药体会

目的　观察并比较静脉注射毛花甙C、艾司洛尔及地尔硫艹卓控制快速房性心律失常心室率的有效性。方法　将2001-03~2003-08中国医学科学院阜外心血管病医院94例快速房性心律失常(房颤、房扑、房速)患者随机分为3组,分别静脉用毛花甙C(29例)、艾司洛尔(30例)和地尔硫(35例)。结果　毛花甙C、艾司洛尔和地尔硫均能有效控制快速房性心律失常的心室率,心室率下降幅度分别为30 .4%、29.3%和27. 6%,总有效率分别为86%、83%和85%,平均用药有效时间分别为( 34. 3±21 .0 )min、( 10. 0±3. 9 )min和( 10 .0±3. 9 )min。结论　艾司洛尔、毛花甙C及地尔硫艹卓均能有效、迅速、安全控制快速房性心律失常的心室率。     

地尔硫卓联合肾上腺素对急性ST段抬高型心肌梗死患者冠状动脉介入无复流的作用

目的观察冠状动脉闭塞段近端注射地尔硫卓及肾上腺素对急性ST段抬高型心肌梗死(STEMI)冠状动脉介入(PCI)中无复流的影响。方法 82例诊断为急性STEMI,行急诊PCI患者,随机分为地尔硫卓组、地尔硫卓+肾上腺素组,每组41例,两组患者均术中行血栓抽吸,分析两组患者冠状动脉支架植入前后分别于冠状动脉内注射地尔硫卓、地尔硫卓联合肾上腺素后,冠状动脉血流(TIMI)及心肌灌注(TMPG)情况。结果支架植入前造影(初次)与手术结束前(末次)盐酸地尔硫卓联合肾上腺素组达到TIMI 3级血流显著高于地尔硫卓组(P0.05),其TMPG 3级比例也高于地尔硫卓组(P0.05),发生低血压及心动过缓事件少于地尔硫卓组。结论盐酸地尔硫卓联合肾上腺素在预防、治疗冠状动脉无复流方面较单纯使用地尔硫卓更有效,其具有减少急诊PCI术中低血压及心动过速的趋势。     

地尔硫卓治疗非ST段抬高型急性冠状动脉综合征难治性心肌缺血的疗效分析

目的研究地尔硫卓静治疗非ST段抬高型急性冠状动脉综合征难治性心肌缺血(NSTEACS-RMI)的临床疗效。方法选择2012年1月~2015年12月于广州市番禺区第二人民医院内科接受治疗的老年NSTEACS-RMI患者124例,按照随机数字表法分为地尔硫卓组(n=64)与对照组(n=60),对照组患者给予阿司匹林、低分子肝素、氯吡格雷、血管紧张素转化酶抑制剂、倍他乐克及他汀类降酯药物等常规药物治疗,地尔硫卓组行常规治疗联合地尔硫卓治疗。治疗7 d后观察两组治疗前后血压、心率、胸痛频率及每次持续时间、心肌缺血程度及范围(以NST表示常规12导联ST段压低在0.2m V以上导联数;以∑ST表示12导联ST段压低之和),NST、∑ST以飞利浦TC30心电图机检测、以美国PI AECG系统检测心率变异性(HRV),记录传导阻滞、心动过缓、心力衰竭、心律失常等不良反应及评估临床疗效。结果治疗后,地尔硫卓组血压、心率、胸痛频率及每次持续时间、含服硝酸甘油次数、NST、∑ST均低于对照组,差异有统计学意义(P均0.05)。治疗后,地尔硫卓组各心率变异性指标均较对照组显著改善,差异有统计学意义(P均0.05)。地尔硫卓组总有效率(90.63%)高于对照组(61.67%),差异有统计学意义(P0.05)。地尔硫卓组不良反应发生率(6.25%)与对照组不良反应发生率(1.56%)比较,差异无统计学意义(P0.05)。结论地尔硫卓可显著改善NSTEACS-RMI患者心肌缺血状态,改善临床症状,不良反应发生率低,值得应用于临床。     

尼可地尔与地尔硫卓治疗经皮冠状动脉介入治疗术后再发不稳定型心绞痛疗效分析

目的研究尼可地尔和地尔硫卓对经皮冠状动脉介入(PCI)术后再发不稳定型心绞痛(UAP)患者的临床疗效。方法入选2015年1月至2016年8月解放军第252医院PCI术后再发UAP患者72例,随机数字表法分为尼可地尔组和地尔硫卓组,每组36例。尼可地尔组患者男性24例,女性12例,年龄48~80(62.61±9.26)岁,常规治疗基础上加服尼可地尔片5 mg,口服,3次/d。地尔硫卓组患者男性21例,女性15例,年龄48~79(61.72±8.18)岁,常规治疗基础上加服地尔硫卓90 mg,口服,2次/d,比较两组患者服药60 d期间每周心绞痛发作次数及持续时间、硝酸甘油服用量、心电图改变及不良反应情况。结果两组患者的年龄、性别、病程、吸烟史、SYNTAX评分、合并疾病差异无统计学意义(P0.05)。相比服药前,服药后两组患者每周心绞痛发作次数、持续时间、硝酸甘油服用量均有所减少,且尼可地尔组明显优于地尔硫卓组,差异有统计学意义(P0.05)。尼可地尔组患者服药有效率88.9%(32/36),地尔硫卓组患者服药有效率75.0%(27/36),两组有效率差异无统计学意义(χ~2=2.347,P=0.126)。相比尼可地尔,地尔硫卓易使患者出现头痛,差异有统计学意义(P0.05)。结论尼可地尔与地尔硫卓均对PCI术后再发UAP有疗效,尼可地尔的临床疗效显著,可明显改善心绞痛症状,并且不良反应少。     

阵发性房颤射频消融术后空白期内房性心律失常与房颤远期复发的关系

目的 探讨阵发性房颤射频消融术后3个月（“空白期”）内房性心律失常的发作趋势与远期复发的关系.方法 入选在我院接受首次环肺静脉电隔离射频消融术的阵发性房颤患者50例,并于术后3个月内每月行24h动态心电图检查,同时进行术后定期临床随访和监测12个月.根据术后第12个月体表心电图、24h动态心电图监测及临床随访结果,分为房颤复发组和无复发组,比较复发组患者与无复发组患者术后3个月内房性心律失常发生率及随着时间推移两组房性心律失常的发作趋势.结果 术后第12个月体表心电图及24h动态心电图统计结果显示,房颤复发率为36.0％（18/50）,所有心电图中出现快速型房性心律失常心电图为26.9％,其中房颤20.2％、房扑2.0％、房速4.7％;房性早搏20.1％;窦性心动过缓2.0％.复发组患者术后3个月内房性心律失常的发生率高于无复发组（41.1％比10.2％,P＜0.05）,复发组患者术后3个月内房性心律失常的发生率维持在较高水平（术后3个月分别为44.4％、41.8％、38.5％,P＞0.05）.无复发组患者术后3个月可出现房颤复发,随着时间推移房性心律失常的发生率呈降低趋势（术后3个月分别为18.7％、10.5％、4.4％,P＜0.01）.结论 早期复发不能代表消融失败和晚期复发,但早期房性心律失常发作频繁,则晚期房颤复发的危险性增加.     

厄贝沙坦或贝那普利联合地尔硫卓对轻中度原发性高血压患者左心室肥厚和无症状性心肌缺血的影响

目的 观察厄贝沙坦或贝那普利联合地尔硫卓对原发性高血压患者左心室肥厚(LVH)及心肌缺血的影响。方法选取2011年1月至2015年4月于福建医科大学附属第一医院干部病房就诊的168例轻中度原发性高血压患者,根据患者的降压方案,分为地尔硫卓组(n=35)、肾素血管紧张素系统阻断剂(RASI)组(厄贝沙坦或贝那普利,n=45)和RASI+地尔硫卓组(厄贝沙坦或贝那普利联合地尔硫卓,n=88)。随访6~18个月。评估治疗前后左心室质量指数(LVMI)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、血压以及心肌缺血总负荷(TIB)的变化。结果与治疗前比较,3组患者治疗后收缩压、舒张压、IVST、LVPWT及LVMI水平降低(均P0.05),RASI+地尔硫卓组患者LVMI低于地尔硫卓组[(104.53±13.50)比(112.80±16.16)g/m2,P0.05],RASI+地尔硫卓组与RASI组治疗后LVMI差异无统计学意义[(104.53±13.50)比(108.11±15.12)g/m2,P0.05];RASI+地尔硫卓组、地尔硫卓组心电图MV5、aVF导联TIB和总TIB在治疗后降低[总TIB:RASI+地尔硫卓组治疗后比治疗前:(1.42±0.59)比(2.26±0.92)mm/(min·24h),地尔硫卓组治疗后比治疗前:(1.25±0.57)比(1.97±0.76)mm/(min·24h);均P0.05],心电图MV1导联TIB治疗前后差异无统计学意义(均P0.05);RASI+地尔硫卓组及地尔硫卓组患者在治疗后各时段(0~6、6~12、12~18及18~24月)总TIB均降低(均P0.05);RASI组在治疗后各时段总TIB变化无统计学意义(均P0.05)。结论厄贝沙坦或贝那普利及地尔硫卓均有降低血压和逆转LVH的作用;地尔硫卓无论是单用还是与厄贝沙坦或贝那普利合用,均可改善心肌缺血。     

地尔硫卓治疗糖尿病性心肌病疗效观察

目的观察口服地尔硫卓对糖尿病性心肌病的临床有效性和安全性。方法41例患者随机分为治疗组21例(地尔硫卓30mg,一日3次,口服,连用30天)和对照组20例,观察LAD、LVDD和LVEF治疗前后变化。结果治疗组和对照组治疗前后LVEF改善均有显著差异(P<0.05),治疗后比较LVEF亦有显著差异(P<0.05),但LAD和LVDD改善无显著差异。结论地尔硫卓对糖尿病性心肌病心功能改善效果良好,且无明显毒副作用。     

丹参酮注射液并地尔硫卓对高血压患者血管内皮功能的影响

目的:探讨丹参酮注射液联合地尔硫卓治疗对高血压患者血管内皮功能的影响。方法:选择我院住院治疗的原发性高血压患者136例,通过随机数字表法分为联合治疗组(应用丹参酮注射液联合地尔硫卓治疗)和地尔硫卓组,各68例,比较治疗前,治疗后2周、1个月两组患者的血压、内皮依赖的舒张功能(EDD)的变化。结果:与治疗前比较,治疗2周及治疗1个月后,两组血压明显下降[治疗前:联合治疗组(168.25±12.54)/(112.47±6.28)mm Hg,地尔硫卓组(168.37±11.74)/(112.49±7.13)mm Hg,治疗2周:(142.37±2.43)/(100.43±5.19)mm Hg比(151.36±6.16)/(109.17±4.76)mm Hg,治疗1个月:(126.71±8.17)/(87.49±5.37)mm Hg比(142.34±6.28)/(94.16±6.28)mm Hg],且联合治疗组血压较地尔硫卓组降低更显著,P均0.01;与治疗前比较,治疗2周及治疗1月后,两组EDD均较治疗前明显提高[治疗前与治疗1个月后比较(4.78±2.30)%比(8.43±4.73)%比(4.74±2.26)%比(6.69±4.60)%],且联合治疗组治疗1个月后EDD值较地尔硫卓组提高更显著(P0.05或0.01)。结论:高血压患者在应用地尔硫卓的同时配合应用丹参酮注射液有助于改善血管内皮功能。     

Diltiazem treatment does not alter renal function after thoracic surgery

BACKGROUND: There are conflicting reports on the effects of diltiazem treatment on renal function in surgical patients. We sought to determine whether diltiazem treatment alters renal function in patients undergoing major thoracic surgery. METHODS: In a prospective study, 330 patients scheduled for elective thoracic surgery received either IV diltiazem (n = 167) or placebo (n = 163) immediately after the operation and orally thereafter for 14 days in an effort to prevent postoperative atrial arrhythmias. Serum creatinine and BUN levels were compared before and during the first postoperative week. RESULTS: Patients treated with diltiazem were similar to control subjects in terms of age (mean +/-SD, 66 +/- 10 years vs 67 +/- 10 years, respectively), baseline serum creatinine or BUN levels, prevalence of comorbid conditions, and surgical characteristics. During the first 5 postoperative days, the two groups did not differ in terms of serum creatinine or BUN levels. The incidence of renal failure was 0.6% in the diltiazem group and 1.2% in the placebo group (difference was not significant). There was no difference in the length of hospitalization or mortality rate. CONCLUSIONS: In patients without renal disease who are undergoing elective thoracic surgery, prophylactic diltiazem treatment did not alter postoperative renal function.     

Effect of diltiazem on cardiac rate and rhythm after myocardial infarction. Multicenter Diltiazem Postinfarction Trial Investigators

The a priori hypothesis that diltiazem would reduce the frequency and repetitiveness of ventricular arrhythmias was tested 3 months after myocardial infarction in patients participating in the Multicenter Diltiazem Postinfarction Trial. After 3 months of follow-up, 1,546 of the 2,466 patients enrolled had a 24-hour continuous electrocardiographic recording that contained greater than or equal to 12 hours of analyzable data. They were similar to the patients who survived 3 months but chose not to have a 24-hour electrocardiographic recording (i.e., they were representative of the entire group that survived 3 months). After 3 months of follow-up, there were no significant differences between the diltiazem and placebo groups in the prevalence of atrioventricular block, the frequency of atrial arrhythmias or the frequency or repetitiveness of ventricular arrhythmias. Heart rate was significantly lower (67 +/- 12 vs 71 +/- 12 beats/min) and there was a significantly greater proportion of patients with sinus pauses greater than or equal to 2 seconds in duration in the diltiazem group (6%) than in the placebo group (3%). Comparison with placebo revealed no evidence either for an anti- or proarrhythmic effect of diltiazem. There was no reduction in sudden or arrhythmic death attributable to diltiazem treatment; the fraction of total deaths that were arrhythmic by the Hinkle classification was 41% in the placebo group and 42% in the diltiazem group. It may be that the lack of effect of diltiazem on ventricular arrhythmias is partially responsible for its lack of effect on mortality after myocardial infarction.     

Diltiazem versus amiodarone to prevent atrial fibrillation in coronary surgery

The prophylactic effect of amiodarone on atrial fibrillation after coronary bypass grafting with extracorporeal circulation was compared with that of diltiazem in two groups of 60 patients each. Patients were monitored continuously for 8 days. The incidence of atrial fibrillation was recorded retrospectively in a control group of 60 patients who received our standard prophylactic regimen of an oral beta blocker. The incidence of postoperative atrial fibrillation was not significantly different in the two test groups: 11.7% for the amiodarone group and 10% for the diltiazem group. The incidence of atrial fibrillation in the control group was 23.3% and the differences were marginally significant when compared to the amiodarone ( p = 0.093) and diltiazem groups ( p = 0.050). The prophylactic use of diltiazem or amiodarone is feasible and safe for patients undergoing coronary bypass, with similar rates of atrial fibrillation.     

Amiodarone prophylaxis for tachycardias after coronary artery surgery: a randomised, double blind, placebo controlled trial.

BACKGROUND--Arrhythmias are a common cause of morbidity after cardiac surgery. This study assessed the efficacy of prophylactic amiodarone in reducing the incidence of atrial fibrillation or flutter and ventricular arrhythmias after coronary artery surgery. METHODS--A double blind, randomised, placebo controlled trial. 60 patients received a 24 hour intravenous infusion of amiodarone (15 mg/kg started after removal of the aortic cross clamp) followed by 200 mg orally three times daily for 5 days, and 60 patients received placebo. RESULTS--6 patients (10%) in the amiodarone group and 14 (23%) in the placebo group needed treatment for arrhythmias (95% confidence interval (95% CI) for the difference between groups was 0 to 26%, p = 0.05). The incidence of supraventricular tachycardia detected clinically and requiring treatment was lower in the amiodarone group (8% amiodarone v 20% placebo, 95% CI 0 to 24%, p = 0.07). The incidence detected by 24 hour Holter monitoring was similar (17% amiodarone v 20% placebo). Untreated arrhythmias in the amiodarone group were either clinically benign and undetected (n = 3) or the ventricular response rate was slow (n = 2). Age > 60 years was a positive risk factor for the development of supraventricular tachycardia in the amiodarone group but not in the placebo group. Fewer patients had episodes of ventricular tachycardia or fibrillation recorded on Holter monitoring in the amiodarone group (15% amiodarone v 33% placebo, 95% CI 3 to 33%, p = 0.02). Bradycardia (78% amiodarone v 48% placebo, 95% CI 14% to 46%, p < 0.005) and pauses (7% amiodarone v 0% placebo) occurred in more amiodarone treated patients. Bradycardia warranted discontinuation of treatment in one patient treated with amiodarone. CONCLUSIONS--The incidence of clinically significant tachycardia was reduced by amiodarone. The ventricular response rate was slowed in supraventricular tachycardia, but the induction of bradycardia may preclude the routine use of amiodarone for prophylaxis.     

Postoperative follow-up of coronary artery bypass patients receiving calcium antagonist diltiazem

We performed a prospective, randomized clinical study on 211 elective coronary artery bypass patients to assess the antiischemic and antiarrhythmic effects of the calcium channel blocker diltiazem. Patients received perioperatively continuous 24-hour infusions of either diltiazem (0.1 mg/kg/hour; n=104) or nitroglycerin (1 µg/kg/minute; n=107). Patients randomized to the diltiazem group were kept on continuous oral diltiazem medication postoperatively (3×50 mg/day). After a postoperative follow-up period of 2 years, 119 of the 211 patients were available for a clinical evaluation: 56 patients randomized to the diltiazem group and 63 patients randomized to the control group. Twenty patients from the diltiazem and 14 control patients did not follow their medicamentation and were excluded from further study. The two groups did not differ with respect to preoperative and surgical data. Postoperatively, the incidence of atrial fibrillation (4.8% vs 18.6%,p<0.05) and the frequency of ventricular premature couplets (VPC)/hour (22±6 vs 37±11,p<0.05), Lown II arrhythmias (VPC >30/hour) (99±19 vs 254±58,p<0.05), and ventricular runs/hour (7±15 vs 38±25,p<0.05) were significantly lower in the diltiazem group. Furthermore, patients of the diltiazem group had significantly lower peak values of ischemia-sensitive laboratory parameters: creatine kinase-MB (17.6±14.3 vs 25.3±16.3 U/L,p<0.05), CK-MB-mass concentration (35.2±38.4 vs 51.5±33.9 µg/L,p<0.05), and troponin-T (0.98±0.7 vs 1.7±0.8 µg/L,p<0.05). Two years after coronary artery bypass surgery, fewer patients randomized to the diltiazem group showed signs of cardiac failure (0 vs 6.1%), ST-segment alterations during exercise (5.5% vs 13.2%,p<0.05), symptoms of angina during exercise (18.5% vs 22.4%, n.s.), atrial fibrillation (0 vs 2.0%), and new left bundle branch block (0 vs 8.2%), compared with controls. It is concluded that the calcium antagonist diltiazem is effective in reducing incidence and extent of arrhythmias and myocardial ischemia perioperatively and provides potent postoperative antiischemic and antiarrhythmic protection in patients after coronary artery bypass surgery.     

The effect of acebutolol on cardiac arrhythmias in patients with chronic coronary artery disease

The effect of the beta-blocking drug acebutolol on the severity of cardiac arrhythmias and the incidence of exercise-induced arrhythmias was studied in 15 patients with chronic coronary artery disease using ambulatory Holter monitoring and bicycle ergometry. We found a significantly lower grading of arrhythmias both on long-term ECGs and during and after exercise. Furthermore, there was a significant decrease in the incidence of VPBs during and after exercise (18.15 +/- 7.7 on placebo vs. 3.46 +/- 1.7 on acebutolol). It is concluded that acebutolol favorably influences the incidence and severity of ventricular arrhythmias in patients with chronic coronary artery disease.     

The role of premature atrial contractions as the main triggers of postoperative atrial fibrillation

To better understand the pathogenesis of postoperative atrial fibrillation (AF), the mode of onset of AF after coronary artery bypass grafting was analyzed with respect to the autonomic balance, the heart rate (HR), and the presence of arrhythmias preceding the onset of sustained AF. METHOD: Holter recordings of 24 hours, obtained from the first postoperative morning until clinically documented sustained AF, were analyzed in 29 untreated patients and in 13 patients treated with thoracic epidural anesthesia (TEA), who all developed AF after coronary artery bypass grafting. The presence of arrhythmias, the HR, and the autonomic balance, assessed by heart rate variability in the frequency domain, were analyzed at predefined time intervals within the 3-hour period before AF onset. Supraventricular premature beats (SPBs) and ventricular premature beats triggering the onset of AF were also evaluated. RESULT: An SPB triggering the onset of AF can be identified in 21 (72.4%) of 29 untreated patients and in 12 (100%) of 12 TEA-treated patients in whom the recordings permitted such an analysis. The heart rate variability components analyzed during 5-minute periods for 30 minutes before AF onset did not differ significantly from those at corresponding times at the first postoperative day in either patient group. The HR during the 8 beats immediately before AF onset was lower in TEA-treated than in untreated patients. CONCLUSION: The finding of an SPB at the onset of postoperative AF in most of the patients and irrespective of changes in HR supports the hypothesis that postoperative AF is primarily triggered by latent focal atrial activity. The autonomic tone did not seem to be of major importance in the population studied.     

Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects

BACKGROUND: The efficacy of magnesium in the prevention of arrhythmias in pediatric patients after heart surgery remains unknown. Therefore we prospectively examined the effect of magnesium treatment on the incidence of postoperative arrhythmias in pediatric patients undergoing surgical repair of congenital heart defects. METHODS AND RESULTS: Twenty-eight pediatric patients undergoing heart surgery with cardiopulmonary bypass were prospectively, randomly assigned in a double-blind fashion to receive intravenous magnesium (magnesium group, n = 13; 30 mg/kg) or saline (placebo group, n = 15) immediately after cessation of cardiopulmonary bypass. Magnesium, potassium, and calcium levels were measured at defined intervals during surgery and 24 hours after surgery. Continuous electrocardiographic documentation by Holter monitor was performed for 24 hours after surgery. Magnesium levels were significantly decreased below the normal reference range for patients in the placebo group compared with the magnesium group on arrival in the intensive care unit and for 20 hours after surgery. Magnesium levels remained in the normal range for patients in the magnesium group after magnesium supplementation. In 4 patients in the placebo group (27%), junctional ectopic tachycardia developed within the initial 20 hours in the intensive care unit. No junctional ectopic tachycardia was observed in the magnesium group (P =.026). CONCLUSIONS: Although this study was originally targeted to include 100 patients, the protocol was terminated because of the unacceptable incidence of hemodynamically significant junctional ectopic tachycardia that was present in the placebo group. Thus low magnesium levels in pediatric patients undergoing heart surgery are associated with an increased incidence of junctional ectopic tachycardia in the immediate postoperative period.     

Perioperative hydrocortisone treatment reduces postoperative pancreatic fistula rate after open distal pancreatectomy. A randomized placebo-controlled trial

BackgroundPostoperative pancreatic fistula (POPF) is the most common complication after distal pancreatectomy (DP). In a recent RCT on pancreaticoduodenectomy (PD), perioperative hydrocortisone (HC) treatment reduced Clavien-Dindo (C-D) III-V complications. The aim of this study was to investigate whether perioperative HC treatment reduces the overall complications and clinically significant POPF after distal pancreatectomy (DP).MethodsFourty consecutive patients undergoing DP were randomized to receive intravenous HC 100mg/placebo every eight hours until the second postoperative day. Thirty-one patients were completed with DP and received HC/placebo every 8 h for two days postoperatively. The primary endpoint was overall complications (C-D III-V) and the secondary endpoint was the development of clinically significant POPF.ResultsPancreatic duct diameter, operative time and blood loss were similar in the groups. Ninety-day mortality was zero. With HC treatment the rates of C-D III-V complications tended to be lower compared to the placebo group (5.9% vs 21.4%, p = 0.034). The rate of grade B/C POPF was significantly reduced with HC treatment compared to the placebo group (5.9% vs. 42.9%, p = 0.028).ConclusionPerioperative HC treatment may have a favourable effect on overall major complications after open DP. HC treatment reduces the incidence of clinically significant POPF after open DP.