胰岛素瘤腹腔镜切除与开腹切除的近远期疗效比较  

Clinical analysis of insulinoma resection: laparoscopy versus laparotomy

作　　者：刘川[1] 胡三元[1] 刘少壮[1] 张光永[1] 王可新[1] 于文滨[1] 

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012

出　　处：《山东大学学报（医学版）》2014年第9期67-71,89,共6页Journal of Shandong University:Health Sciences

摘　　要：目的：评估腹腔镜胰岛素瘤切除术的安全性以及比较腹腔镜和开腹胰岛素瘤切除术的临床特点。方法采用回顾性收集分析临床资料，2004年7月至2013年11月共51例胰岛素瘤患者，分别行腹腔镜胰岛素瘤切除术（腹腔镜组，14例）和开腹胰岛素瘤切除术（开腹组，37例），比较两组手术时间、术中出血量、术后住院天数及并发症。结果比较腹腔镜组和开腹组的肿瘤直径[（1．55±0．66）cm vs （1．57±0．54）cm]、术中出血量[（47．85±40．03）mL vs（57．89±34．73）mL]、手术时间[（177．30±63．00）min vs （161．38±51．91）min]、术后住院天数[（13．0±5．39）d vs （15．97±8．91）d]，未见明显统计学差异。腹腔镜组并发症仅见1例胰漏，开腹组合并胰漏3例，术后出血1例，胸腹腔积液8例，其他并发症4例，前者明显优于后者（P＜0．05）。术后随访中，腹腔镜组随访3～65个月，复发1例（46个月），开腹组随访6～69个月，复发2例，平均复发时间为34．5个月，但未达到统计学差异。结论胰体和胰尾的胰岛素瘤行腹腔镜下单纯切除，是一种安全且有效的手术方式，相对于传统开腹有并发症少、术后住院天数略缩短、复发时间略延长等优点。Objective To evaluate the safety and efficacy of laparoscopic and laparotomy resection of insulinoma. Methods Clinical data of 51 cases of insulinnoma collected from July 2004 to Nov.2013 were retrospectively ana-lyzed,including 14 cases who underwent laparoscopy （laparoscopic group）and 37 cases receiving laparotomy （laparot-omy group）.The operation time,volume of blood loss,postoperative hospital stay and complications were compared. Results There was no significant difference between the diameter of tumor [（1.55 ±0.66）cm vs （1.57 ±0.54） cm],volume of blood loss[（47.85 ±40.03）mL vs （57.89 ±34.73）mL],operation time[（177.30 ±63.00）min vs （161.38 ±51.91）min],and postoperative hospital stay[（13.0 ±5.39）d vs （15.97 ±8.91）d]in the laparoscopic group and laparotomy group.The laparoscopic group had 1 case of pancreatic fistula,while the laparotomy group had 3 cases of pancreatic fistula,1 case of postoperative bleeding,8 cases of abdominal effusion and 4 cases with other com-plications.The laparoscopic group had fewer complications than the laparotomy group （P〈0.05）.In postoperative fol-low-up,the laparoscopic group （3 ~65 months）had 1 case of recurrence （46 months）,while the laparotomy group （6~69 months）had 2 cases （34.5 months）.The recurrence time of the laparoscopic group was longer than that of the laparotomy group,but there was no statistical difference.Conclusion Laparoscopic resection of insulinoma located on the body or tail of pancreas is a safe and effective surgical approach,with fewer complications,shorter postoperative hospital stay and longer recurrence time than traditional laparotomy.

关 键 词：胰岛素瘤 腹腔镜 开腹 预后 

分 类 号：R657.4[医药卫生—外科学]