腹腔镜胰体尾切除术与开腹胰体尾切除术临床疗效对比  

Comparison of clinical efficacy of laparoscopic distal pancreatic resection and open distal pancreatic resection

作　　者：胡欢欢 钟志惟 宁克 王超[1] 袁春晖 殷香保[1] HU Huanhuan;ZHONG Zhiwei;NING Ke;WANG Chao;YUAN Chunhui;YIN Xiangbao.(Department of Hepatopancreatobiliary Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院肝胆胰外科

出　　处：《实用医学杂志》2019年第16期2560-2563,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号：81760439)

摘　　要：目的对腹腔镜胰体尾切除术(laparoscopic distal pancreatectomy,LDP)与开腹胰体尾切除术(open distal pancreatectomy,ODP)的治疗效果进行比较分析,并探讨LDP的优缺点。方法回顾性分析2014年1月至2018年4月在南昌大学第二附属医院施行的22例LDP患者与20例ODP患者的临床资料,对两组患者的手术及术后情况进行比较分析。结果两组患者均顺利完成胰体尾切除术。在术中出血量上,LDP组少于ODP组[(155.63±39.26)mL vs.(255.42±118.63)mL,P<0.05];术后禁食时间分别(4.21±0.92)d和(4.68±0.76)d,肛门排气时间分别为(2.26±0.73)d和(2.87±0.52)d,住院时间分别为(9.27±3.68)d和(12.31±4.73)d,LDP组较ODP缩短,差异均具有统计学意义(P<0.05);在手术时间上,LDP组长于ODP组[(258.32±42.52)min vs.(186.56±34.28)min,P<0.05];LDP组和ODP组的保脾率和术后并发症发生率差异无统计学意义(P>0.05)。LDP组和ODP组术后病理结果均显示标本切缘为阴性。结论LDP是安全有效的,外科疗效与ODP相当,短期预后效果明显高于ODP,值得在临床上推广应用。Objective To compare the clinical efficacy of laparoscopic distal pancreatectomy(LDP)and open distal pancreatectomy(ODP).To investigate the advantages and disadvantages of LDP.Methods The clinical data of 22 patients undergone LDP and 20 patients undergone ODP at the Second Affiliated Hospital of Nanchang University from January 2014 to April 2018 were analyzed retrospectively.Results Both groups of patients successfully completed the distal pancreatectomy.Intraoperative blood loss in LDP group were less than that in ODP group[(155.63±39.26)mL vs.(255.42±118.63)mL,P<0.05].The postoperative fasting time(4.21±0.92)d vs.(4.68±0.76)d,anal exhaust time(2.26±0.73)d vs.(2.87±0.52)d and hospital stays(9.27±3.68)d vs.(12.31±4.73)d in LDP group were shorter than that in ODP group(all P<0.05).Surgery duration in LDP were longer than ODP[(258.32±42.52)min vs.(186.56±34.28)min,P<0.05].There was no statistically significant difference in the rates of spleen-preserving and incidence of postoperative complication between two groups(P>0.05).The pathological results of LDP group and ODP group showed that the specimen margins were negative.Conclusion LDP is safe and effective.Its surgical efficacy is equal to ODP.The short-term efficacy of LDP is significantly better than that of ODP,so it deserves to be promoted in clinical practice.

关 键 词：腹腔镜胰体尾切除术 开腹胰体尾切除术 胰腺肿瘤 

分 类 号：R657.5[医药卫生—外科学]