三维可视化技术在胰头癌胰腺全系膜切除术中应用研究  

Application of three-dimensional visualization technique in total mesopancreas excision(TMp E) for pancreatic head carcinoma

作　　者：梁海滨[1] 吴文广[1] 李茂岚[1] 王许安[1] 吴向嵩[1] 龚伟[1] 王雪峰[1] 方驰华[2] 刘颖斌[1] LIANG Hai-bin;WU Wen-guang;LI mao-lan(Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Research Center of Biliary Tract Disease, Shanghai Key Laboratory of Biliary Tract Disease, Shanghai 200092, China)

机构地区：[1]上海交通大学医学院附属新华医院普外科上海市胆道疾病研究中心上海市胆道疾病研究重点实验室,上海200092 [2]南方医科大学珠江医院肝胆一科,广东广州510282

出　　处：《中国实用外科杂志》2019年第1期92-95,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金国际合作项目(No.31620103910);上海市级医院新兴前沿技术项目(No.SHDC12014109)

摘　　要：目的探讨三维可视化技术在胰头癌胰腺全系膜切除术中的应用价值。方法回顾性分析2013年1月至2017年6月在上海交通大学医学院附属新华医院普外科行胰腺全系膜切除的105例胰头癌病人资料,采用三维可视化技术对胰头肿瘤的部位、大小、与周围血管的毗邻关系进行观察,完成术前可切除性的评估,共施行胰腺全系膜切除术105例。结果平均手术时间239 min,平均术中出血409 mL。29例(27.6%)发生术后并发症,无围手术期死亡病例。74例标本三维空间切缘病理学检查达到R0切除,R0切除率为70.5%。结论三维可视化技术在胰头癌全系膜切除术前规划中的应用,可以更好地指导胰头癌的精准手术,提高了术前评估的准确率与手术的R0切除率,降低手术并发症发生率。Objective To evaluate the application of three-dimensional visualization technique in total mesopancreas excision (TMpE) for pancreatic head carcinoma. Methods From January 2013 to June 2017, 105 TMpE for pancreatic head carcinoma were performed in our institution, and clinical data of these cases were analyzed retrospectively. In order to evaluate the feasibility of operation, three-dimensional visualization techniques were applied to observe the site and size of the pancreatic head tumors, and the relationship between the tumors and peripancreatic vessels before the operation. Results The median operation time was 239 minutes, and the median blood loss was 409 mL. 29 cases with postoperative complications and no perioperative deaths. 74 patients were considered as R0 resection in final three-dimensional pathologic examination, and the rate of R0 resection is 70.5%. Conclusion Preoperative application of three-dimensional visualization technique in TMpE can improve preoperative assessment accuracy and increase the rate of R0 resection, in addition to reduce postoperative complications.

关 键 词：胰头癌 胰腺全系膜切除 R0切除 三维可视化 

分 类 号：R6[医药卫生—外科学]