胰腺中段切除术的学习曲线  

Learning curve for middle pancreatectomy

作　　者：汤小龙[1] 张建伟[1] 车旭[1] 陈应泰[1] 兰忠民[1] 王成锋[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院腹部外科,100021

出　　处：《中华肿瘤杂志》2015年第10期793-795,共3页Chinese Journal of Oncology

摘　　要：目的：探讨胰腺中段切除手术的学习曲线。方法收集2006年1月至2014年4月行胰腺中段切除手术的48例患者的临床资料。按手术先后顺序，以每5例为一学习阶段，将所有患者分为10个阶段，对比分析各阶段患者在手术时间、术中出血量、手术并发症、切缘阴性率及术后住院时间等方面的差异。结果各阶段手术患者的切缘阴性率、术后并发症及中位术后住院时间差异均无统计学意义（均P＞0．05）。第1阶段患者的中位手术时间、中位术中出血量分别为375 min和530 ml，第2阶段分别为280 min和330 ml，与其余各阶段比较，差异均有统计学意义（均P＜0．01）。第3～10阶段患者的中位手术时间、中位术中出血量差异无统计学意义（ P＞0．05）。结论胰腺中段切除手术经过10～15例手术可达较熟练和稳定程度，同时并发症发生率较低。Objective To explore the learning curve for middle pancreatectomy by comparing the outcomes of middle pancreatectomy operated by a single treatment group at different stages. Methods A total of 48 patients received middle pancreatectomy by single treatment group between January 2006 and April 2014 at our hospital. These 48 cases were divided into 10 stages （ 5 cases in each） according to the operation sequence. The operation time, blood loss, surgical complications, rate of negative margin and postoperative hospital stay were analyzed retrospectively. Results There was no significant difference among the 10 stages in respect to surgical complications, rate of negative margin and postoperative hospital stay （ P〉0.05） . The median operation time and blood loss in the first stage was 375 min and 530 ml, respectively. The median operation time and blood loss in the second stage was 280 min and 330 ml, respectively. There were significant differences between these two stages and the other later stages in median operation time and blood loss （ P〈0.01） . However, there was no significant difference among the stages 3 to 10 in the median operation time and blood loss （ P〉0.05 for all） . Conclusion After 10？15 cases of middle pancreatectomy, a surgeon can be skilled and experienced in this surgical procedure with few surgical complications.

关 键 词：胰腺切除术 手术后并发症 学习曲线 

分 类 号：R657.5[医药卫生—外科学]