完全腹腔镜下胰腺钩突部肿瘤切除术的临床疗效分析(附3例报告)  

Clinical analysis complete laparoscopic resection of uncinate process tumor of pancreas(3 cases)

作　　者：曾志武 邓次妮 刘莉 夏辉[4] 杨光耀[4] 陈冬 周程[4] 龚昭[4] 王炜煜 Zhi-wu Zeng;Ci-ni Deng;Li Liu;Hui Xia;Guang-yao Yang;Dong Chen;Cheng Zhou;Zhao Gong;Wei-yu Wang(Department of General Surgery,Shenzhen University General Hospital,Shenzhen,Guangdong 518000,China;Cardiac Vascular Disease Diagnosis and Treatment Center,Shenzhen People’s Hospital,Shenzhen,Guangdong 518001,China;Department of Laboratory Medicine,General Hospital of Center Theater Command,Wuhan,Hubei 430015,China;Department of Hepatobiliary Surgery,Wuhan No.1 Hospital,Wuhan,Hubei 430022,China;Department of Hepatobiliary Diseases,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,China)

机构地区：[1]深圳大学总医院普外科,广东深圳518000 [2]深圳市人民医院心脏血管疾病诊疗中心,广东深圳518001 [3]中部战区总医院检验中心,湖北武汉430015 [4]武汉市第一医院肝胆外科,湖北武汉430022 [5]武汉大学中南医院肝胆疾病研究院,湖北武汉430071

出　　处：《中国内镜杂志》2022年第5期74-79,共6页China Journal of Endoscopy

基　　金：深圳市医学重点学科建设经费资助(No:SZXK003)。

摘　　要：目的探讨完全腹腔镜下手术切除治疗胰腺钩突部肿瘤的临床疗效。方法回顾性分析深圳大学总医院2017年3月以来3例行完全腹腔镜下胰腺钩突部肿瘤切除术的患者的临床资料,总结围手术期处理方法及临床效果。结果3例患者均于完全腹腔镜下完成手术,术后1例有A级胰瘘,经应用胰酶抑制剂和肠外营养支持等治疗后痊愈;1例发生胃肠道功能障碍,经胃肠减压和肠外营养支持治疗后痊愈;1例神经内分泌肿瘤患者手术切除肿瘤后症状缓解,未再发作低血糖昏迷,空腹及餐后血糖水平明显升高,血清胰岛素水平均较术前明显降低,恢复正常胰岛素分泌波峰。无出血和腹腔感染等严重并发症发生;无围手术期死亡病例。3例患者术后均痊愈出院,随访13~47个月无异常。结论完全腹腔镜下胰腺钩突部肿瘤切除术安全可行,疗效好,可用于胰腺钩突部良性或神经内分泌肿瘤的切除。Objective To explore the indications,methods and perioperative management of complete laparoscopic resection for uncinate process tumor of pancreas,then provide guidance for clinical work.Methods Three patients with uncinate process tumor of pancreas underwent complete laparoscopic resection since March 2017 were retrospectively analyzed,including perioperative management and the clinical effect.Result Three patients underwent completely laparoscopic surgery,1 patient with A-grade pancreatic fistula,after the application of pancreatic enzyme inhibitors,parenteral nutrition support and other treatment was cured;1 patient with gastrointestinal dysfunction,after gastrointestinal decompression,parenteral nutrition support treatment was cured.The symptoms of 1 patient with neuroendocrine tumor were relieved after tumor resection,and hypoglycemic coma did not occur again.Fasting and postprandial blood glucose levels were significantly increased,the serum insulin level decreased significantly and returned to normal peak of insulin secretion.No serious complications such as bleeding and abdominal infection occurred.There was no perioperative death.All the three patients recovered after surgery and discharged,and no abnormalities were observed during the follow-up of 13 to 47 months.Conclusion Complete laparoscopic resection of uncinate process tumor of pancreas is safe,feasible and effective,which can be used for the resection of benign or neuroendocrine tumor of uncinate process of pancreas.

关 键 词：腹腔镜 胰腺钩突部肿瘤 神经内分泌肿瘤 低血糖 胰瘘 

分 类 号：R735.9[医药卫生—肿瘤]