Postoperative biological and clinical outcomes following uncomplicated pancreaticoduodenectomy

Emilie Lermite; Tao Wu; Alain Sauvanet; Christophe Mariette; François paye; Fabrice Muscari; Antonio Sa Cunha; Bernard Sastre; Jean-Pierre Arnaud; Patrick Pessaux

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저자정보: Emilie Lermite (Université d’Angers) Tao Wu (Hospital of Kunming) Alain Sauvanet (Université Paris VII) Christophe Mariette (Université de Lille) François paye (UPMC Paris VI) Fabrice Muscari (Université de Toulouse) Antonio Sa Cunha (Université de Bordeaux) Bernard Sastre (Université de Marseille) Jean-Pierre Arnaud (Université d’Angers) Patrick Pessaux (Université de Strasbourg)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제20권 제1호

발행연도: 2016.2

수록면: 23 - 31 (9page)

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Backgrounds/Aims: The aim of this study was to describe clinical and biological changes in a group of patients who underwent pancreaticoduodenectomy (PD) without any complication during the postoperative period. These changes reflect the “natural history” of PD, and a deviation should be considered as a warning sign. Methods: Between January 2000 and December 2009, 131 patients underwent PD. We prospectively collected and retrospectively analyzed demographic data, pathological variables, associated pathological conditions, and preoperative, intraoperative, and postoperative variables. Postoperative variables were validated using an external prospective database of 158 patients. Results: The mean postoperative length of hospital stay was 20.3±4 days. The mean number of days until removal of nasogastric tube was 6.3±1.6 days. The maximal fall in hemoglobin level occurred on day 3 and began to increase after postoperative day (POD) 5, in patients with or without transfusions. The white blood cell count increased on POD 1 and persisted until POD 7. There was a marked rise in aminotransferase levels at POD 3. The peak was significantly higher in patients with hepatic pedicle occlusion (866±236 IU/L versus 146±48 IU/L; p＜0.001). For both γ-glutamyl transpeptidase and alkaline phosphatase, there was a fall on POD1, which persisted until POD 5, followed with a stabilization. Bilirubin decreased progressively from POD 1 onwards. Conclusions: This study facilitates a standardized biological and clinical pathway of follow-up. Patients who do not follow this recovery indicator could be at risk of complications and additional exams should be made to prevent consequences of such complications.

#Pancreaticoduodenectomy #Complication #Natural history #Biological test

참고문헌 (41)

참고문헌 신청

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