https://scholars.lib.ntu.edu.tw/handle/123456789/457159
標題: | Late acute pancreatitis after pancreaticoduodenectomy: incidence, outcome, and risk factors | 作者: | HUNG-HSUAN YEN Ho, Te-Wei CHIEN-HUI WU TING-CHUN KUO JIN-MING WU CHING-YAO YANG YU-WEN TIEN |
公開日期: | 2019 | 出版社: | Blackwell Publishing Asia | 卷: | 26 | 期: | 3 | 起(迄)頁: | 109-116 | 來源出版物: | Journal of Hepato-Biliary-Pancreatic Sciences | 摘要: | Background: The pancreatoenteric anastomotic stricture (PEAS) is a common long-term complication after pancreaticoduodenectomy (PD), some of which present as acute pancreatitis requiring emergency care. This important topic has never been reported. In this study, we focus on the incidence, radiological features, clinical outcome, and risk factors of late-occurring acute pancreatitis (LAP) after PD. Methods: We retrospectively reviewed a prospectively collected database of 539 patients who underwent PD at a single tertiary referral center between June 2005 and December 2014. Only patients with at least 3?years of follow-up and available pre- and post-operative images were included. Results: Of the 539 patients, 23 (15 [65%] with and eight [35%] without PEAS) were diagnosed with LAP after PD. The cumulative incidence of LAP was 3.6% (1-year), 4.4% (2-year), and 5.1% (5-year). The median time to the first LAP episode was 22?months (range 8–38?months) after PD. All the first and recurrent LAP events were mild in severity and resolved after conservative treatment. Multivariate analysis showed that a history of acute pancreatitis before PD (P?=?0.001, HR?5.24, 95% CI?1.95–14.10) and PEAS (P?=?0.047, HR?2.75, 95% CI?1.01–7.49) were two significant risk factors. Conclusions: We propose using a more conservative treatment for patients who experience LAP after PD. ? 2019 Japanese Society of Hepato-Biliary-Pancreatic Surgery |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061814813&doi=10.1002%2fjhbp.606&partnerID=40&md5=5eff8194290bf4d6c9ee372429e0fb14 https://scholars.lib.ntu.edu.tw/handle/123456789/457159 |
ISSN: | 1868-6974 | DOI: | 10.1002/jhbp.606 | SDG/關鍵字: | acute pancreatitis; adult; aged; Article; clinical feature; cohort analysis; computer assisted tomography; conservative treatment; controlled study; disease severity; female; follow up; human; incidence; late occurring acute pancreatitis; major clinical study; male; nuclear magnetic resonance imaging; pancreaticoduodenectomy; pancreaticojejunostomy; parenteral nutrition; postoperative period; preoperative period; retrospective study; risk factor; acute disease; adverse event; anastomosis; jejunum; middle aged; pancreas; pancreas disease; pancreaticoduodenectomy; pancreatitis; stenosis, occlusion and obstruction; time factor; Acute Disease; Aged; Anastomosis, Surgical; Constriction, Pathologic; Female; Humans; Incidence; Jejunum; Male; Middle Aged; Pancreas; Pancreatic Diseases; Pancreaticoduodenectomy; Pancreatitis; Retrospective Studies; Risk Factors; Time Factors |
顯示於: | 醫學系 |
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