腹腔镜远端胰腺切除术与开腹手术疗效的对比研究  

Comparative study on curative effect of laparoscopic versus open distal pancreatectomy

作　　者：朱中飞[1] 宋彬[1] 马洪运[1] 欧阳柳[1] 李刚[1] 何天霖[1] 张怡杰[1] 金钢[1] 

机构地区：[1]第二军医大学长海医院胰腺外科,上海200433

出　　处：《外科理论与实践》2015年第5期408-411,共4页Journal of Surgery Concepts & Practice

基　　金：上海长海医院"1255学科建设计划创新探索项目"(CH125541400)

摘　　要：目的 :比较腹腔镜和开腹手术治疗胰体尾肿瘤的临床疗效。方法 :回顾性分析我院2012年10月至2013年12月92例胰腺良性或交界性肿瘤病人的临床资料,其中42例行腹腔镜远端胰腺切除术(laparoscopic distal pancreatectomy,LDP),含10例保留脾脏,50例行开腹远端胰腺切除术(open distal pancreatectomy,ODP),含3例保留脾脏。比较两组病人一般资料、手术时间、术中出血量、住院天数、术后并发症及住院费用。结果 :LDP组与ODP组病人一般情况基本一致,LDP组体质量指数显著高于ODP组(24.79比23.18,P=0.001)。LDP组手术时间较ODP组长,有统计学差异(153.19 min比119.19 min,P<0.001)。LDP组术中出血量、进食开始时间、术后住院天数均明显低于ODP组,差异有统计学意义(P<0.05)。两组术后胰漏发生率无统计学差异(33.3%比36.0%,P>0.05),LDP组住院费用较ODP组高,但无统计学差异(4.49万元比4.29万元,P>0.05)。结论 :LDP对于良性或交界性胰体尾肿瘤的病人安全可行。Objective To compare the clinical outcomes of laparoscopic distal pancreatectomy（LDP） with those of open distal pancreatectomy （ODP） for the tumors of body and tail of the pancreas. Methods Ninty-two patients with the benign or borderline tumors of pancreas were analyzed retrospectively from October 2012 to December 2013 including 42 patients of LDP with 10 spleen-preserving and 50 patients of ODP with 3 spleen-preserving. Patient characteristics, blood loss, operative time, length of hospital stay, postoperative complications and overall costs were compared between 2 groups. Results The demographic data were similar between LDP and ODP except for body mass index, which was higher in LDP group than in ODP group （24.79 vs 23.18, P=0.001）. There was a significant difference of operative time between LDP and ODP （153.19 rain vs 119.19 rain, P〈0.001）. The patients in LDP group had less blood loss, postoperative time to restarting diet, shorter length of postoperative stay than the patients in ODP group （P〈0.05）, while postoperative complications between 2 groups were similar in terms of pancreatic fistula （33.3% vs 36.0%, P〉0.05）. The overall costs in LDP group were more than in ODP group with no statistical significance （4.49×10^4 RMB vs 4.29×10^4 RMB, P〉0.05）. Conclusions LDP has the advantages of safety and feasibility for benign or borderline tumors of body and tail of the pancreas.

关 键 词：腹腔镜 远端胰腺切除 胰腺肿瘤 

分 类 号：R735.9[医药卫生—肿瘤]