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The purpose of this study was to determine the safety and efficacy of early drain removal and triple-drug therapy (TDT) with gabexate mesilate, octreotide and carbapenem antibiotics to prevent PF after DP in patients at high-risk of developing PF. Methods A total 71 patients who underwent a DP were enrolled. We prospectively divided them into two groups: the late-removal group, in which the drain remained in place for at least for 5 days postoperatively (n = 30) and the early-removal group in which the drain was removed on postoperative day 1 (POD1) (n = 41). For the patients with a high drain amylase level (?10,000 IU/L) and patients with symptomatic intraperitoneal fluid collection, our original TDT was introduced. The primary endpoint was the safety and efficacy of this management, and the secondary endpoint was the incidence of PF. Results The incidence of clinical PF was significantly lower in the early-removal group (0% vs. The late removal 16%; p \u003c 0.001). 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Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy
http://hdl.handle.net/10069/35784
http://hdl.handle.net/10069/357849b93b1a5-d1a2-450b-9416-8521d6d0ba1e
名前 / ファイル | ライセンス | アクション |
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Panc15_411.pdf (834.5 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2016-07-02 | |||||
タイトル | ||||||
タイトル | Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Distal pancreatectomy | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Drain amylase level | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Early drain removal | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Intraperitoneal fluid collection | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Pancreas fistula | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Triple-drug therapy | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Adachi, Tomohiko
× Adachi, Tomohiko× Kuroki, Tamotsu× Kitasato, Amane× Hirabaru, Masataka× Matsushima, Hajime× Soyama, Akihiko× Hidaka, Masaaki× Takatsuki, Mitsuhisa× Eguchi, Susumu |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Objective Prior studies suggested that early drain removal prevented the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD), but there has been no corresponding prospective trial for distal pancreatectomy (DP). The purpose of this study was to determine the safety and efficacy of early drain removal and triple-drug therapy (TDT) with gabexate mesilate, octreotide and carbapenem antibiotics to prevent PF after DP in patients at high-risk of developing PF. Methods A total 71 patients who underwent a DP were enrolled. We prospectively divided them into two groups: the late-removal group, in which the drain remained in place for at least for 5 days postoperatively (n = 30) and the early-removal group in which the drain was removed on postoperative day 1 (POD1) (n = 41). For the patients with a high drain amylase level (?10,000 IU/L) and patients with symptomatic intraperitoneal fluid collection, our original TDT was introduced. The primary endpoint was the safety and efficacy of this management, and the secondary endpoint was the incidence of PF. Results The incidence of clinical PF was significantly lower in the early-removal group (0% vs. The late removal 16%; p < 0.001). In the early-removal group, TDT was administered to 12 patients (29%) and none of the patients needed additional treatment after TDT. Conclusions Postoperative management after DP with early drain removal and TDT was safe and effective for preventing PF. | |||||
書誌情報 |
Pancreatology 巻 15, 号 4, p. 411-416, 発行日 2015-07-01 |
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出版者 | ||||||
出版者 | IAP and EPC | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 14243903 | |||||
DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1016/j.pan.2015.05.468 | |||||
権利 | ||||||
権利情報 | c 2015 IAP and EPC. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Pancreatology, 15(4), pp.411-416; 2015 |