腹腔镜胰十二指肠切除术340例报告  

Laparoscopic pancreaticoduodenectomy:A report of 340 cases

作　　者：刘军[1] 许世峰[1] 杨凤辉[1] 李春友[1] 于光圣[1] 公伟[1] 孟凡迎[1] 徐延田[1] 李光兵[1] 郑顺贞[1] 曹昱琨 郑元文[1] 王建平[1] 司伟 LIU Jun;XU Shi-feng;YANG Feng-hui(Department of Hepatobiliary Surgery,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China)

机构地区：[1]山东大学附属省立医院器官移植肝胆外二科

出　　处：《中国实用外科杂志》2020年第2期203-207,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目（No.81770646）

摘　　要：目的探讨腹腔镜胰十二指肠切除术(LPD)可行性。方法回顾性分析2017年3月至2019年7月山东大学附属省立医院器官移植肝胆外二科开展的340例LPD病人临床资料。结果男性234例,女性106例。平均年龄(59.0±12.4)岁,平均手术时间(230.5±24.6)min,胆肠吻合时间平均(13.5±2.6)min,胰肠吻合时间平均(15.2±3.5)min,胃空肠吻合时间平均(12.2±2.3)min,术中出血量平均(275.4±53.2)mL,术后住院时间平均(11.2±4.5)d。术后发生胰瘘60例(17.65%),胆瘘32例(9.41%),胃瘫53例(15.59%),大出血22例(6.47%),围手术期死亡5例(1.47%)。结论对于有丰富开放胰十二指肠切除手术经验及一定腹腔镜手术操作经验的中心,LPD是一种安全、可行的手术方式。Objective To evaluate clinical feasibility of laparoscopic pancreaticoduodenectomy(LPD)in perioperative period.Methods The clinical data of 340 consecutive cases who underwent LPD admitted in Department of Hepatobiliary Surgery of Shandong Provincial Hospital Affiliated to Shandong University from March 2017 to July 2019 were analyzed retrospectively.ResultsThe LPDs were successfully completed in the 340 patients.Among them,234 patients were male and 106 female,aged(59.0±12.4)years on average.The operative time was(230.5±24.6)min,the pancreaticojejunostomy time was(15.2±3.5)min,the bilioenteric anastomosis time was(13.5±2.6)min and the gastrojejunostomy time was(12.2±2.3)min.The intraoperative blood loss was(275.4±53.2)mL.The duration of postoperative hospital stay was(11.2±4.5)days.Postoperative pancreatic fistula occurred in 60 cases(17.65%)and bile fistula in 32 cases(9.41%).Postoperative gastroparesis was found in 53 cases(15.59%).Postoperative hemorrhage in 22 cases(6.47%).Perioperative mortality was in 5 cases(1.47%).ConclusionLPD is safe and feasible for the team with rich experience in open pancreaticoduodenectomy and certain laparoscopic surgery.

关 键 词：胰十二指肠切除术 腹腔镜 

分 类 号：R6[医药卫生—外科学]