腹腔镜与开腹胰十二指肠切除术的短期临床效果回顾性分析  

Short-term clinical outcomes of laparoscopic pancreaticoduodenectomy versus open pancreatoduodenectomy: a retrospective analysis

作　　者：杨帆[1,2] 钟国超 游科 刘作金[1] YANG Fan;ZHONG Guochao;YOU Ke;LIU Zuojin(Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;Department of General Surgery, the People’s Hospital of Chishui, Chishui, Guizhou 564700, P. R. China)

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010 [2]赤水市人民医院普通外科,贵州赤水564700

出　　处：《中国普外基础与临床杂志》2019年第6期685-690,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的比较腹腔镜胰十二指肠切除术(laparoscopic pancreaticoduodenectomy,LPD)和开腹胰十二指肠切除术(open pancreatoduodenectomy,OPD)的短期临床效果。方法收集重庆医科大学附属第二医院肝胆外科从 2016 年 3 月至 2018 年 12 月期间由同一主刀医师同期完成的 29 例 LPD 患者和 27 例 OPD 患者的临床资料,分析 2 组手术的有效性和安全性。结果LPD 组和 OPD 组患者在年龄、性别、体质量指数、总胆红素水平、直接胆红素水平、术前合并疾病、病灶大小、TNM 分期和 ASA 分级方面比较差异均无统计学意义(P>0.05);LPD组的手术时间明显长于 OPD 组[(482±86)min 比(349±73) min,P<0.01];与 OPD 组相比,LPD 组患者术后肛门排气时间明显早于 OPD 组[(3.3±0.8)d 比(5.3±1.0)d,P<0.05];2 组的术后住院时间、术中失血量、术中输血人数、二次手术次数、术后患者死亡情况和术后并发症发生方面比较差异均无统计学意义(P>0.05)。结论本研究的初步结果提示,与 OPD 相比,LPD 可缩短患者的术后肛门排气时间,但并不增加术后并发症发生率和术中失血量。该结论仍需更大样本量的临床研究来证实。Objective To compare the short-term clinical outcomes of laparoscopic pancreaticoduodenectomy (LPD) with open pancreatoduodenectomy (OPD). Methods Clinical data of 29 patients receiving LPD and 27 patients receiving OPD in the department of hepatobiliary surgery of the Second Affiliated Hospital of Chongqing Medical University from March 2016 to December 2018 were collected. Note that both LPD and OPD were performed by the same chief surgeon. Effectiveness and safety of LPD were compared with those of OPD. Results There was no significant difference in age, sex, body mass index, total bilirubin level, direct bilirubin level, preoperative morbidities, focus size, TNM stage and ASA grade between the LPD group and the OPD group (P>0.05). The operative time of the LPD group was significantly longer than that of the OPD group [(482±86 ) min vs.(349±73) min, P<0.01]. Patients in the LPD group had shorter postoperative anal exhaust time than that in the OPD group [(3.3±0.8) d vs.(5.3±1.0) d , P<0.05]. There was no significant difference in the length of hospital stay after operation, blood loss in operation, transfusion, second operation, death and postoperative complications between the LPD group and the OPD group (P>0.05). Conclusions The preliminary results of this study suggest that compared with OPD, LPD can shorten the postoperative anal exhaust time but not increase the incidence of postoperative complications and blood loss in operation. Nevertheless, this conclusion is needed to be validated by clinical studies with large sample size.

关 键 词：腹腔镜 胰十二指肠切除术 短期疗效 

分 类 号：R657.5[医药卫生—外科学]