腹腔镜与开腹胃癌根治术后早期并发急性胰腺炎的临床回顾性分析  

A clinical retrospective comparison for post-gastrectomy acute pancreatitis between laparoscopic surgery vs.open surgery in the treatment of gastric cancer

作　　者：吴川清[1] 刘炜圳 赵刚[2] 高金波[1] 帅晓明[1] 张鹏[1] 王国斌[1] 陶凯雄[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院胃肠外科,武汉430022 [2]华中科技大学同济医学院附属协和医院胰腺外科

出　　处：《腹部外科》2016年第4期310-313,共4页Journal of Abdominal Surgery

基　　金：中国卫计委公益性行业基金项目(201402015)

摘　　要：目的本研究分析腹腔镜手术和开腹手术在胃癌治疗中伴发急性胰腺炎(post--gastrectomy acute pancreatitis,PGAP)的优劣性。方法收集2011年6月至2015年9月施行胃癌根治术的病人1050例。分别统计腹腔镜组和开腹组术后PGAP病例,并做回顾性分析对比研究。结果1050例胃癌根治术中并发PGAP的16例,发生率为1.52%,腹腔镜组432例,PGAP 7例,发生率为1.62%;开腹组618例,PGAP 9例,发生率为1.46%。腹腔镜组与开腹组术后PGAP发生率比较差异无统计学意义(x^2=0.046,P>0.05)。腹腔镜组中远端胃251例,PGAP 1例(0.40%);近端胃78例,PGAP 1例(1.28%);全胃83例,PGAP 2例(2.41%);联合脏器切除20例,PGAP 3例(15.00%)。远端胃、近端胃和全胃切除术后PGAP发生率比较差异无统计学意义(P>0.05),但三者与联合脏器切除术后PGAP发生率比较差异有统计学意义(P<0.05)。开腹组中远端胃213例,PGAP 3例(1.41%);近端胃182例,PGAP 1例(0.55%);全胃174例,PGAP 2例(1.15%);联合脏器切除49例,PGAP 3例(6.12%)。结果类似腹腔镜组,远端胃、近端胃和全胃切除术后PGAP发生率比较差异无统计学意义(P>0.05),但三者与联合脏器切除术后PGAP发生率比较差异有统计学意义(.P<0.05)。腹腔镜组与开腹组分别对远端胃、近端胃、全胃和联合脏器切除后PGAP的发生率比较,差异均无统计学意义(P>0.05)。结论腹腔镜与传统开腹胃癌根治术对于PGAP具有同样安全性。Objective To compare advantages and disadvantages between laparoscopic surgery and open surgery in the treatment of gastric cancer with post-gastrectomy acute pancreatitis （PGAP）. Methods 1050 cases of gastric cancer undergoing gastrectomy were collected at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology between June 2011 and Sep- tember 2015. PGAP cases were retrospectively analyzed in laparoscopic surgery group and open sur- gery group. Results There were 16 cases of PGAP in 1 050 patients with gastric cancer with the inci- dence being 1.52%. There were 7 cases of PGAP in 432 cases of laparoscopic surgery group with the incidence being 1.62%, and 9 cases of PGAP in 618 cases of open surgery group with the incidence being 1.46% （χ2 = 0. 046, P〉0. 05）. In laparoscopic surgery group, there was 1 case of PGAP in 251 cases of middle-distal gastrectomy （0. 40%）, 1 case of PGAP in 78 cases of proximal gastrectomy （1.28%）, 2 cases of PGAP in 83 cases of total gastrectomy, and 3 cases of PGAP in 20 cases of multi-visceral resection （15.00%）. The incidence of PGAP among middle-distal gastrectomy, proxi-real gastrectomy and total gastrectomy showed no statistically significant difference （P〈0. 05）, but the incidence of all of that had significant difference from the multi-visceral resection group （P〈 0. 05）. In open surgery group, there were 3 cases of PGAP in 213 cases of middle-distal gastrectomy （1.14%）, 1 case of PGAP in 182 cases of proximal gastrectomy （0. 55%）, 2 cases of PGAP in 174 cases of total gastrectomy, and 3 cases of PGAP in 49 cases of multi-visceral resection （6. 12%）. Sim- ilar to the laparoscopic group, the incidence of PGAP among middle-distal gastrectomy, proximal gas- trectomy and total gastrectomy showed no statistically significant difference （P〉0. 05）, but the inci- dence of all of that had significant difference from the multi-visceral resection in open surgery group （P 〈0. 05）. In the groups of mi

关 键 词：胃癌根治术 术后并发症 急性胰腺炎 腹腔镜手术 开腹手术 

分 类 号：R735.2[医药卫生—肿瘤]