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OBJECTIVE: To discuss whether grade B pancreatic fistula after pancreaticoduodenectomy(PD)can be graded according to the severity and to provide reference for accurate evaluation and treatment.METHODS: The clinical data of 343 patients underwent PD surgery in the First Affiliated Hospital of Harbin Medical University from December2012 to June 2016 were retrospectively collected,among which 72 cases followed grade B pancreatic fistula. Grade B pancreatic fistula after operation was divided into severe groups of which imaging-assisted interventional therapy was needed and mild group. The total medical cost,length of hospital stay,drainage time,ICU transfer,introperitoneal effusion,introabdominal infection,abdominal hemorrhage,biliary fistula,delayed gastric emptying,number of types and incidence of complications except pancreatic fistula,incidence of pancreatic fistula as the most serious complications,postoperative morbidity index(PMI),fistula average complication burden(ACB)were statistically analyzed between two groups.RESULTS: Univariate analysis revealed that there were significant differences between two groups in the total medical cost(84,000 yuan vs. 132,000 yuan),length of hospital stay(29.0 days vs. 42.0 days),drainage time(20.5 d vs.53.0 d),introperitonal effusion rate(41.1% vs. 87.5%),introabdominal infection rate(10.7% vs. 43.8%),abdominal hemorrhage rate(7.1% vs. 56.3%),the number of other types of complications except pancreatic fistula(1 vs. 4),pancreatic fistula as the most serious complications(53.6% vs. 87.5%),PMI(0.22±0.08 vs. 0.37±0.00),ACB(0.19±0.08 vs. 0.37±0.00),and the P-values were less than 0.05 respectively.CONCLUSION: The severity of grade B pancreatic fistula of ISGPS update classification is heterogeneous,which can be divided into mild and severe groups. It provides a reference for precise and individualized treatment for grade B pancreatic fistula.
RESUMEN
<p><b>OBJECTIVE</b>To evaluate the quality of life (QOL) in the patients with chronic hepatitis C (CHC) after PEG-Interferon a-2a therapy.</p><p><b>METHODS</b>A study based on 102 CHC patients (group A, before PEG- Interferon a-2a therapy, T0) and 44 healthy persons (group B) was carried out using the general quality of life inventory (GQOLI-74) questionnaire, and QOL were compared between the two groups. Patients in group A were divided into subgroup A1 (72 patients ) which was given PEG-Interferon a-2a plus Ribavirin for one year and subgroup A2 (30 patients) without any antivirus therapy. QOL of patients in these two subgroups was investigated using GQOLI-74 questionnaire on the end of PEG-Interferon a-2a plus Ribavirin therapy (T1) and half one year after the end of PEG-Interferon a-2a plus Ribavirin therapy (T2). QOL of CHC patients (group A1 and A2) were compared at T0, T1 and T2, respectively.</p><p><b>RESULTS</b>Compared with group B, patients in group A had lower QOL (P < 0.05) on other scales and total scores of the GQOLI-74 questionnaire except psychological function(P > 0.05). Both on T1 and T2, patients in subgroup A1 had higher QOL on physical function, psychological function, social function and total scores than patients in subgroup A2 at the same time (P < 0.05). Patients in subgroup A1 at T1 had higher QOL on physical function, psychological function, social function and total scores than at T0 (P < 0.05). Patients in subgroup A1 at T2 had higher QOL on social function than that at T1 (P < 0.05).</p><p><b>CONCLUSIONS</b>QOL of CHC patients is more impaired than healthy persons. PEG-Interferon a-2a therapy will improve the QOL.</p>