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Objective:To investigate the risk factors for delayed gastric emptying (DGE) following pancreaticoduodenectomy (PD).Methods:Clinical data of 385 patients who underwent PD in Changhai Hospital of Navy Medical University from January 2017 to November 2017 were retrospectively analyzed, including 235 men and 150 women. According to the definition of DGE by the International Study Group of Pancreatic Surgery (ISGPS), patients were divided into-clinically irrelevant DGE (non CR-DGE) group and clinically relevant DGE(CR-DGE) group. Univariate analysis and multivariate logistic analysis were used to identify the risk factors of CR-DGE after PD.Results:Of the 385 patients, 78 cases (20.3%) developed DGE. There were 35 cases of CR-DGE (9.1%). In the multivariate analysis, BMI( OR=1.117, 95% CI1.006-1.240, P=0.038), preoperative serum albumin( OR=0.902, 95% CI 0.832-0.977, P=0.012), the main pancreatic duct diameter (MPD)≤3 mm( OR=2.397, 95% CI 1.016-5.653, P=0.046), soft texture of pancreas( OR=2.834, 95% CI 1.093-7.350, P=0.032), clinically relevant postoperative pancreatic fistula (CR-POPF)( OR=4.498, 95% CI 1.768-11.441, P=0.002) were independent risk factors for CR-DGE after PD. Conclusions:High BMI, low preoperative serum albumin, MPD ≤3 mm, soft texture of pancreas and CR-POPF after surgery were independent risk factors for CR-DGE, and early clinical interventions should be performed.
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Objective@#To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET).@*Methods@#Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases. Related factors on diagnosis and treatment were summarized. Moreover, univariate survival analysis was performed by Kaplan-Meier method, and COX proportional hazards model was used for multivariate survival analysis.@*Results@#The detection rates of the B-ultrasound, CT, MRI were 60.2%, 84.6% and 91.3%, respectively, and there were 44 cases located in pancreatic head, 18 cases in pancreatic neck and 41 cases in pancreatic body and tail.G1 was the most common pathological grade, and the positive rates of Chromogranin A, Syn, neuron-specific enolase and CAM5.2 were 97.1%, 97.1%, 91.3% and 93.2%, respectively. The results of statistical analysis showed that tumor grade(χ2=26.077, P<0.05), Ki-67 index(χ2=25.427, P<0.05), ENETS stage(χ2=5.915, P<0.05), AJCC stage(χ2=8.411, P<0.05), lymph node metastasis(χ2=4.770, P<0.05) and distant metastasis(χ2=8.411, P<0.05) were associated with the prognosis of pNET, and the tumor grade was an independent risk factor of the pNET′ overall prognositic factors (HR=3.085, P<0.01).@*Conclusions@#The pNET can be located in any part of pancreas, and the combination of laboratory and various imaging examinations can help make early diagnosis. In addition, tumor grade, Ki-67 index, ENETS stage, AJCC stage, lymph node metastasis and distant metastasis were closely related to the prognosis of pNET, and the higher the tumor grade, the worse the prognosis.
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To investigate the psychological difference in abdominal aortic aneurysm patients before and after operation and its influence on life quality, 24 patients who can understand and complete the questionnaire were enrolled in the study, the inquiry was performed after admission and discharge with the standard SCL 90 table. The results showed that the general conditions, depression, anxiety, compulsive symptoms and fear of the patients had marked differences before and after operation. It is concluded that operation of abdominal aortic aneurysm can not only prevent the rupture of aneurysm but also relieve the patients′ psychological pressuer and improve their life quality.