术前减轻黄疸对壶腹部癌行Whipple手术治疗效果的影响

目的:探讨术前减轻黄疸对壶腹部癌患者行Whipple手术治疗效果的影响。方法:回顾性分析2012年1月—2018年7月45例在Whipple手术术前行减轻黄疸治疗的壶腹部癌患者(减轻黄疸组)的临床资料,与同期34例行Whipple手术术前未行减轻黄疸治疗的壶腹部癌患者(未减轻黄疸组)的临床资料进行比较。比较两组患者术前、术中情况(手术时间、出血量、输血量)和术后并发症的差异。结果:减轻黄疸组患者治疗后总胆红素(TBil)、结合胆红素(DBil)、谷丙转氨酶(ALT)与治疗前比较差异有统计学意义(P<0.05)。两组R 0切除率比较差异无统计学意义(P>0.05)。减轻黄疸组手术时间、术中出血量、术中输血量优于未减轻黄疸组,差异均有统计学意义(P<0.05)。减轻黄疸组术后并发症发生率、胰漏发生率和胆漏发生率少于未减轻黄疸组,差异均有统计学意义(P<0.05)。结论:壶腹部癌患者行Whipple手术术前彻底减轻黄疸,可以缩短手术时间,减少术中出血量和术后并发症的发生。

Effects of preoperative jaundice relieving on Whipple of ampullary cancer

Objective:To investigate the effects of preoperative jaundice relieving on Whipple of ampullary cancer.Methods:Retrospective analysis of the clinical data of 45 patients with ampullary cancer who were relieved of jaundice before the Whipple surgery(reducing the jaundice group)from January 2012 to July 2018,and 34 patients who did not relieve jaundice before the operation of Whipple surgery Clinical data were compared between patients with abdominal cancer(not relieved of jaundice).Comparison of preoperative and intraoperative conditions(operation time,blood loss,blood transfusion)and postoperative complications between the two groups.Results:There was significant difference in the reduction of total bilirubin(TBil),bilirubin(DBil)and alanine aminotransferase(ALT)between the jaundice group and the patients before treatment(P<0.05).There was no significant difference in the R 0 resection rate between the two groups(P>0.05).The operation time,intraoperative blood loss and intraoperative blood transfusion in the jaundice group were better than those in the jaundice group(P<0.05).The incidence of postoperative complications,the incidence of pancreatic leakage and the incidence of bile leakage in the jaundice group were better than those in the jaundice group(P<0.05).Conclusion:Preoperative jaundice relieving on Whipple of ampullary cancer could shorten the operation time and reduce the volume of intraoperative blood loss and incidence of postoperative complications.