机器人辅助腔镜肝胆胰脾手术并发症144例分析  

Complications of robotic assisted laparoscopic surgery for hepatobiliary and pancreatic spleen surgery(144 cases report)

作　　者：王硕[1] 辛洋[1] 张斌[1] 臧运金[1] 吴力群[1] WANG Shuo;XIN Yang;ZHANG Bin;ZANG Yun-jin;WU li-qun(Liver Disense Center,The Affiliated Hospital of Qingdao University,Qingdao 266000,Chian)

机构地区：[1]青岛大学附属医院肝脏病中心,山东青岛266000

出　　处：《中国现代普通外科进展》2020年第12期945-948,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:分析机器人辅助腔镜肝胆胰脾手术术后并发症的类型及影响因素,为手术开展提供参考。方法:2014年11月至2017年12月,机器人辅助腔镜肝胆胰脾手术144例资料和随访结果,分析并发症发生的影响因素。结果:144例患者中男69例,女75例,发生近期并发症40例,远期并发症20例。单因素分析显示,手术部位、术前有无合并症对术后近期并发症的发生率有着重要影响(P<0.05)。多因素分析示,无论近期并发症或是远期并发症,胰腺手术并发症发生率高于其他部位的手术。胰腺手术的近期并发症以胰瘘和出血为主,远期并发症以胰腺断端的包裹性积液为主。结论:胰腺疾病的患者行机器人辅助腔镜手术易发生术后近期及远期并发症,但其远期并发症多无较大危险性。Objective:To analyze the types and influencing factors of postoperative complications of robotic assisted laparoscopic hepatobiliary and pancreatic spleen surgery,and to provide reference for the development of robotic assisted laparoscopic surgery for hepatobiliary and pancreatic.Methods:The clinical data and follow-up results of patients undergoing robot-assisted laparoscopic hepatobiliary and pancreatic surgery from November 15,2014 to December 18,2017 were retrospectively collected to identify the influencing factors of complications.Results:A total of 147 patients underwent the surgery,3 of whom finally had open surgery.Of the 144 patients enrolled in the study,69 were males and 75 were females,of whom 40 had short-term complications and 20had long-term complications.Univariate analysis showed that surgical site and preoperative comorbidities have an important impact on the incidence of postoperative complications(P<0.05).Multivariate analysis suggested that pancreatic surgery was an independent risk factor for postoperative short-term complications of robot-assisted laparoscopic hepatobiliary and pancreatic surgery.Regardless of recent complications or long-term complications,the incidence of complications from pancreatic surgery is higher than in other sites.The short-term complications of pancreatic surgery are mainly pancreatic fistula and hemorrhage,and the long-term complications are mainly the effusion of the pancreas.Conclusions:Patients with pancreatic disease undergoing robot-assisted laparoscopic surgery are prone to short-term and long-term complications,but there is no great harmful long-term complications.

关 键 词：机器人手术 肝胆胰脾手术 并发症 

分 类 号：R616[医药卫生—外科学] R619[医药卫生—临床医学]