[1]李龙李源齐伟峻邴运韬张利王行雁李磊马朝来原春辉修典荣.微创胰十二指肠切除术后达到教科书式结局影响因素的初步探讨[J].中国微创外科杂志,2025,01(7):405-410.
　Li Long,Li Yuan,Qi Weijun,et al.Preliminary Study on Influencing Factors of Textbook Outcome After Minimally Invasive Pancreaticoduodenectomy[J].Chinese Journal of Minimally Invasive Surgery,2025,01(7):405-410.
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微创胰十二指肠切除术后达到教科书式结局影响因素的初步探讨()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年7期
页码:
405-410
栏目:
临床研究
出版日期:
2025-07-30

文章信息/Info

Title:
Preliminary Study on Influencing Factors of Textbook Outcome After Minimally Invasive Pancreaticoduodenectomy
作者:
李龙李源齐伟峻邴运韬张利王行雁李磊马朝来原春辉修典荣
(北京大学第三医院普通外科，北京100191)
Author(s):
Li Long;  Li Yuan;  Qi Weijun;  et al.
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
教科书式结局; 胰腺导管腺癌; 微创胰十二指肠切除术; 胰漏
Keywords:
Textbook outcome; Pancreatic ductal adenocarcinoma; Minimally invasive pancreaticoduodenectomy; Pancreatic fistula
文献标志码:
A
摘要:
目的探讨胰腺导管腺癌患者微创胰十二指肠切除术(minimal invasive pancreaticoduodenectomy，MIPD)后达到教科书式结局(textbook outcome，TO)的影响因素。方法回顾性分析2020年1月~2022年12月我院MIPD治疗101例胰腺导管腺癌的临床资料，根据纳入和排除标准，最终89例进入本研究，其中61例达到TO(TO组)，28例未达到TO(未达到 TO组)。将单因素分析P<0.05的变量纳入多因素logistic回归分析TO的预后因素。结果单因素分析显示胰管扩张>3 mm、术前中性粒细胞/淋巴细胞比值(neutrophil lymphocyte ratio，NLR)、延长住院时间、术后住院时间、术后1～3 d引流液淀粉酶（drain fluld amylase,DFA）>1100 U/L差异有显著性(P<0.05)。多因素logistic回归分析显示TO独立预后因素：胰管扩张>3 mm(OR=7290，95% CI：1.485～35.786，P=0.014)、术后住院时间(OR=0.862，95% CI：0.751～0.989，P=0034)、术后第1天DFA>1100 U/L(OR=0.052，95% CI：0.005～0.545，P=0.014)。结论MIPD术后患者达到TO与手术方式（机器人辅助胰十二指肠切除术或腹腔镜胰十二指肠切除术）无关。胰管扩张>3 mm、术后住院时间、术后第1天DFA>1100 U/L是胰腺导管腺癌患者MIPD术后达到TO的独立预后因素。
Abstract:
ObjectiveTo investigate influencing factors of textbook outcome (TO) in patients with pancreatic ductal adenocarcinoma undergoing minimally invasive pancreaticoduodenectomy (MIPD).MethodsA retrospective analysis was conducted on the clinical data of 101 cases of pancreatic ductal adenocarcinoma treated with MIPD in our hospital from January 2020 to December 2022. According to the inclusion and exclusion criteria, 89 cases were ultimately included in this study, of which 61 cases reached TO (TO group) and 28 cases did not reach TO (nonTO group). Variables with P<0.05 in univariate analysis were included in multivariate logistic regression analysis to identify independent prognostic factors of TO.ResultsUnivariate analysis showed that there were significant differences in pancreatic duct dilation >3 mm, preoperative neutrophil lymphocyte ratio (NLR), extended hospital stay, postoperative hospital stay, and drain fluid amylase(DFA)>1100 U/L at 1-3 d after surgery (P<0.05). Multivariate logistic regression analysis showed that the independent prognostic factors affecting TO were: pancreatic duct dilation >3 mm（OR=7290, 95%CI: 1.485-35.786, P=0.014）, postoperative hospital stay (OR=0.862, 95%CI: 0.751-0.989, P=0034), and the DFA on the first postoperative day >1100 U/L (OR=0.052, 95%CI: 0.005-0.545, P=0.014).ConclusionsThe outcome of TO in patients after MIPD is not related to the surgical approach(robot assisted minimally invasive pancreaticoduodenectomy or laparoscopic pancreaticoduodenectomy). Pancreatic duct dilation >3 mm, postoperative hospital stay, and DFA on the first postoperative day >1100 U/L are independent prognostic factors of TO after MIPD in patients with pancreatic ductal adenocarcinoma.

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备注/Memo

备注/Memo:
通讯作者，Email:xiudianrong@163.com
更新日期/Last Update: 2025-09-18