结肠下区动脉入路在腹腔镜胰十二指肠切除术中的应用  

Application of Artery Approach in the LoweRColon Region Inlaparoscopic Pancreaticoduodenectomy

作　　者：杨楠[1] 王庆大 孙楼宗 Yang Nan;Wang Qingda;Sun Louzong(Department of Hepatobiliary Surgery,The First People′s Hospital of Zigong,Zigong,Sichuan 643000,China.)

机构地区：[1]自贡市第一人民医院肝胆外科,四川自贡643000

出　　处：《四川医学》2021年第9期923-926,共4页Sichuan Medical Journal

摘　　要：目的探讨经结肠下区动脉入路途径行腹腔镜胰十二指肠切除术(LPD)的可行性及优劣。方法回顾性分析18例经结肠下区动脉入路LPD患者的临床资料,分析钩突离断处理时间、手术时间、术中出血量,术后并发症情况及住院时间等指标。结果18例术后顺利恢复后出院,3例术后出现胰瘘,2例术后出现胃瘫均经保守治疗后痊愈。术中钩突系膜离断处理时间(41±8)min,术中平均出血量为(542±194)ml,平均手术时间(452±63)min,未发生围手术期死亡。结论经结肠下区动脉入路途径行腹腔镜胰十二指肠切除术安全可行,受患者局部解剖因素影响小并可增加R0切除率可完成常规入路难以完成的LPD。Objective To investigate the feasibility and effectiveness of artery approach in the loweRcolon region in laparoscopic pancreaticoduodenectomy(LPD).Methods The clinical data of 18 cases that underwent LPD by artery approach in the loweRcolon region were retrospected and analyzed.Parameters such as intraoperative hemorrhage volume,operation time,dissection time of uncinate process,postoperative complications,postoperative hospital days were analyzed statistically.Results 18 cases had been discharged afteRrecovery from surgery.Postoperative complications were observed in 5 cases,including 3 cases of pancreatic fistula and 2 cases of delayed gastric emptying who were all cured afteRconservative therapy.The hemorrhage volume was(542±194)ml.The mean operation time was(452±63)min.The dissection time of uncinate process was(41±8)min.No death was observed during the perioperative period.Conclusion The artery approach in the loweRcolon region in LPD is safe and feasible,and can improve the R0 resection rate with slight influence of patients partial anatomical factors,which boosts the success rate of LPD foRpatients with vasculaRinvasion.

关 键 词：胰十二指肠切除术 腹腔镜 动脉入路 结肠下区 

分 类 号：R656.6[医药卫生—外科学]