臨床外科79巻4号

2024年04月発行

特集 エキスパートに聞く！膵頭十二指腸切除のすべて 総論

膵頭十二指腸切除の周術期管理と合併症

著者： 植松陽介¹ 北郷実¹ 八木洋¹ 阿部雄太¹ 長谷川康¹ 堀周太郎¹ 田中真之¹ 浜野郁美¹ 北川雄光¹

所属機関： ¹慶應義塾大学医学部外科

ページ範囲：P.386 - P.390

【ポイント】
◆膵液瘻などの合併症を減らす努力と準備を怠らないことは重要である．
◆周術期リハビリテーションと栄養管理は重要である．
◆膵内外分泌機能を管理することは重要である．

参考文献

1）Kajiwara Y, Takahashi A, Ueno H, et al：Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan. Ann Gastroenterol Surg 7：367-406, 2023

2）Hayashi K, Abe Y, Kitago M, et al：Prognostic impact of preoperative skeletal muscle change from diagnosis to surgery in patients with perihilar cholangiocarcinoma. Ann Gastroenterol Surg 7：523-532, 2023

3）Dietz JH, Jr：Adaptive rehabilitation of the cancer patient. Curr Probl Cancer 5：1-56, 1980

4）大森まいこ：がんのリハビリテーショントピックス—“prehabilitation”，骨転移．Jpn J Rehabil Med 54：34-45，2017

5）Nakajima H, Yokoyama Y, Inoue T, et al：Clinical Benefit of Preoperative Exercise and Nutritional Therapy for Patients Undergoing Hepato-Pancreato-Biliary Surgeries for Malignancy. Ann Surg Oncol 26：264-272, 2019

6）Bassi C, Marchegiani G, Dervenis C, et al：The 2016 update of the International Study Group（ISGPS）definition and grading of postoperative pancreatic fistula：11 Years After. Surgery 161：584-591, 2017

7）Callery MP, Pratt WB, Kent TS, et al：A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg 216：1-14, 2013

8）Endo Y, Kitago M, Shinoda M, et al：Clinical Impact of Portal Vein Distance on Computed Tomography for Postoperative Pancreatic Fistula after Pancreatoduodenectomy. World J Surg 45：2200-2209, 2021

9）Van Buren G, 2nd, Bloomston M, Hughes SJ, et al：A randomized prospective multicenter trial of pancreaticoduodenectomy with and without routine intraperitoneal drainage. Ann Surg 259：605-612, 2014

10）Dai M, Liu Q, Xing C, et al：Early Drain Removal is Safe in Patients With Low or Intermediate Risk of Pancreatic Fistula After Pancreaticoduodenectomy：A Multicenter, Randomized Controlled Trial. Ann Surg 275：e307-e314, 2022

11）Hashimoto D, Satoi S, Yamamoto T, et al：Validation of the triple-checked criteria for drain management after pancreatectomy. J Hepatobiliary Pancreat Sci 29：271-281, 2022

12）Taniguchi K, Matsuyama R, Yabushita Y, et al：Prophylactic drain management after pancreaticoduodenectomy without focusing on the drain fluid amylase level：A prospective validation study regarding criteria for early drain removal that do not include the drain fluid amylase level. J Hepatobiliary Pancreat Sci 27：950-961, 2020

13）Beane JD, House MG, Ceppa EP, et al：Variation in Drain Management After Pancreatoduodenectomy：Early Versus Delayed Removal. Ann Surg 269：718-724, 2019

14）Abe K, Kitago M, Shinoda M, et al：High risk pathogens and risk factors for postoperative pancreatic fistula after pancreatectomy；a retrospective case-controlled study. Int J Surg 82：136-142, 2020

15）Nakano Y, Endo Y, Kitago M, et al：Clinical characteristics and predictive factors of postoperative intra-abdominal abscess after distal pancreatectomy. Langenbecks Arch Surg 408：170, 2023

16）Wente MN, Bassi C, Dervenis C, et al：Delayed gastric emptying（DGE）after pancreatic surgery：a suggested definition by the International Study Group of Pancreatic Surgery（ISGPS）. Surgery 142：761-768, 2007

17）Hanna MM, Gadde R, Tamariz L, et al：Delayed Gastric Emptying After Pancreaticoduodenectomy：Is Subtotal Stomach Preserving Better or Pylorus Preserving? J Gastrointest Surg 19：1542-1552, 2015

18）Xiao Y, Hao X, Yang Q, et al：Effect of Billroth-Ⅱ versus Roux-en-Y reconstruction for gastrojejunostomy after pancreaticoduodenectomy on delayed gastric emptying：A meta-analysis of randomized controlled trials. J Hepatobiliary Pancreat Sci 28：397-408, 2021

19）Su AP, Cao SS, Zhang Y, et al：Does antecolic reconstruction for duodenojejunostomy improve delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy? A systematic review and meta-analysis. World J Gastroenterol 18：6315-6323, 2012

20）Zhou Y, Hu B, Wei K, et al：Braun anastomosis lowers the incidence of delayed gastric emptying following pancreaticoduodenectomy：a meta-analysis. BMC Gastroenterol 18：176, 2018

21）Kimura K, Minagawa R, Izumi T, et al：Ligation of left gastric vein may cause delayed gastric emptying after pancreatoduodenectomy：a retrospective study. BMC Gastroenterol 22：398, 2022

22）Kabir T, Tan HL, Syn NL, et al：Outcomes of laparoscopic, robotic, and open pancreatoduodenectomy：A network meta-analysis of randomized controlled trials and propensity-score matched studies. Surgery 171：476-489, 2022

23）日本消化器病学会：慢性膵炎診療ガイドライン2021（改定第3版）．南江堂，2021

24）Moore JV, Tom S, Scoggins CR, et al：Exocrine Pancreatic Insufficiency After Pancreatectomy for Malignancy：Systematic Review and Optimal Management Recommendations. J Gastrointest Surg 25：2317-2327, 2021

25）Okano K, Murakami Y, Nakagawa N, et al：Remnant pancreatic parenchymal volume predicts postoperative pancreatic exocrine insufficiency after pancreatectomy. Surgery 159：885-892, 2016

26）Owyang C, Logsdon CD：New insights into neurohormonal regulation of pancreatic secretion. Gastroenterology 127：957-969, 2004

27）Eddes EH, Masclee AM, Gooszen HG, et al：Effect of duodenum-preserving resection of the head of the pancreas on endocrine and exocrine pancreatic function in patients with chronic pancreatitis. Am J Surg 174：387-392, 1997

28）Beger HG, Poch B, Mayer B, et al：New Onset of Diabetes and Pancreatic Exocrine Insufficiency After Pancreaticoduodenectomy for Benign and Malignant Tumors：A Systematic Review and Meta-analysis of Long-term Results. Ann Surg 267：259-270, 2018

29）Kang MJ, Jung HS, Jang JY, et al：Metabolic effect of pancreatoduodenectomy：Resolution of diabetes mellitus after surgery. Pancreatology 16：272-277, 2016

30）Fukuda T, Bouchi R, Takeuchi T, et al：Importance of Intestinal Environment and Cellular Plasticity of Islets in the Development of Postpancreatectomy Diabetes. Diabetes Care 44：1002-1011, 2021