腹腔镜胰体尾切除术110例  

Laparoscopic distal pancreatectomy： report of 110 cases

作　　者：陈灵华[1] 牟一平[1] 严加费[1] 徐晓武[1] 金巍巍[1] 黄超杰[1] 陈荣高[1] 鲁超[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院普外科浙江大学微创外科研究所,杭州310016

出　　处：《中华普通外科杂志》2015年第5期340-343,共4页Chinese Journal of General Surgery

基　　金：省重大科技专项（2011C3036-2）;浙江省卫生厅医药卫生平台骨干人才计划（2013HCBOIO）

摘　　要：目的 总结腹腔镜胰体尾切除术（laparoscopic distal pancreatectomy,LDP）的临床应用经验及手术策略.方法 回顾性分析我院自2003年11月至2013年6月所施行110例LDP的临床资料.结果 本组110例患者中2例中转开腹,其余均在腹腔镜下完成.腹腔镜保留脾脏胰体尾切除术33例,6例合并多脏器切除;联合脾脏切除75例,20例合并多脏器切除.本组110例平均手术时间203±54 min（70 ～410 min）,平均术中出血量167 ±87 ml（30 ～800 ml）;平均术后下床活动时间1.2±0.6d（1～4d）,术后平均禁食时间2.1±1.2d（1～6d）,术后住院时间7.3±3.8 d（3～35d）.总体并发症发生率为17.3％,无围手术期死亡.胰瘘12例,胰瘘发生率为10.9％,其中1例经二次手术治愈,其余病例经保守治疗治愈.结论 对于具有开腹胰体尾切除手术基础的术者,腹腔镜手术治疗胰腺体尾部占位性病变是安全可行的.Objective To summarize the clinical experience and operation strategy of laparoscopic distal pancreatectomy （LDP）.Methods Data of 1 10 cases of laparoscopic distal pancreatectomy from November 2003 to June 2013 in our hospital were retrospectively analyzed.Results LDP procedure was completed successfully in 110 patients except 2 cases were converted to open surgery,including 33 cases of laparoscopic spleen-preserving distal pancreatectomy （LSPDP）,75 cases of laparoscopic distal pancreatectomy plus splenectomy （LDPS）.The mean operation time was 203 ± 54 min （70-410 min）,the mean intraoperative blood loss was 167 ± 87 ml（30-800 ml）,the mean postoperative off-bed time was 1.2 ± 0.6 d（1-4 d）,the mean fasting time was 2.1 ± 1.2 days（1-6 d）,the mean postoperative hospital stay was 7.3 ± 3.8 d （3-35 d）,the rate of overall postoperative complication was 17.3 %,including 12 cases of pancreatic fistula.There was no perioperative death.The rate of pancreatic fistula was 10.9%;One case was cured by reoperation,the others were cured by conservative therapy.Conclusions For surgeons experienced with open distal pancreas surgery,LDP is safe and feasible.

关 键 词：胰腺肿瘤 胰腺切除术 腹腔镜 

分 类 号：R657.5[医药卫生—外科学]