低流量医院行“全腹腔镜下胰十二指肠切除术”临床研究  

Clinical study of"total laparoscopic pancreaticoduodenectomy"in low-flow hospitals

作　　者：满泉[1] 庞慧芳 郭雅明[1] 邵志远[1] 陈艳哲 祁向军[1] Man Quan;Pang Huifang;Guo Yaming;Shao Zhiyuan;Chen Yanzhe;Qi Xiangjun(Department of Hepatobiliarypancreatic Surgery,TongLiao Hospital,Tongliao 028000,China)

机构地区：[1]通辽市医院肝胆胰外科,028000

出　　处：《国际生物医学工程杂志》2021年第4期313-317,共5页International Journal of Biomedical Engineering

基　　金：内蒙古自治区科技计划项目(2020GG0232)。

摘　　要：目的探讨低流量医院开展全腹腔镜下“结肠后入路,钩突先行”胰十二指肠切除技术的安全性、可行性及临床价值。方法分析通辽市医院于2020年1月至2020年8月收治的3例行完全腹腔镜下胰十二指肠切除术患者的临床资料。结果3例患者均成功完成全腹腔镜下胰十二指肠切除术。手术时间各为430、385、425 min;术中出血量各为550、420、400 ml;术后均未见胰瘘、胆漏、肠瘘。术后均未见胃排空障碍,排气时间为术后第4天、第5天、第5天,均于术后第6天拔出胃管及进流食,腹腔引流管拔出时间均为第7天、第7天、第9天;术后恢复均良好,术后住院时间各为18、15、16 d。术后病理诊断:1例为胰头高-中分化导管腺癌;1例为十二指肠壶腹高-中分化腺癌;1例为十二指肠乳头高分化腺癌。结论“结肠后入路,钩突先行”全腹腔镜下胰十二指肠切除术方法安全、可行,可在低流量医院临床推广。Objective To explore the safety,feasibility and clinical value of the"posterior colon approach,uncinate process first"of total laparoscopic pancreaticoduodenectomy in low volume hospitals.Methods The clinical data of 3 patients who underwent complete laparoscopic pancreaticoduodenectomy were analyzed from January 2020 to August 2020.Results All the 3 patients successfully underwent total laparoscopic pancreaticoduodenectomy.For the 3 patients,the operative time was 430,385 and 425 min,and the blood loss was 550,420 and 400 ml.After the operation,no pancreatic fistula,bile leakage,intestinal fistula and astric emptying disorder were found in the patients.The exhaust time of the 3 patients was 4,5 and 5 days after the operation,respectively.On the 6th day after the operation,the gastric tube was removed.The extraction time of the abdominal drainage tube of the 3 patients was the 7th,7th and the 9th day,and the postoperative hospital stay was 18,15 and 16 days,respectively.Postoperative pathological diagnosis results showed that the 3 patients included 1 case of pancreatic head high-moderately differentiated ductal adenocarcinoma,1 case of duodenal ampullary high-moderately differentiated adenocarcinoma,and 1 case of duodenal papillary well-differentiated adenocarcinoma.Conclusions"Posterior approach of uncinate process"is safe and feasible in laparoscopic pancreaticoduodenectomy.It can be popularized in low volume hospitals.

关 键 词：胰十二指肠切除术 腹腔镜 钩突先行 

分 类 号：R657.5[医药卫生—外科学]