腹腔镜胰腺中段切除术21例临床体会  

Clinical experience of laparoscopic pancreatic neck resection:with a report of 21 cases

作　　者：乐乾尊 王海彪 陈佰文[1] 李宏[1] LE Qian-zun;WANG Hai-biao;CHEN Bai-wen(Department of Hepatobiliary Surgery,Ningbo Medical Center of Lihuili Hospital,Ningbo 315000,China)

机构地区：[1]宁波市医疗中心李惠利医院肝胆外科,浙江宁波315000

出　　处：《腹腔镜外科杂志》2023年第6期416-419,425,共5页Journal of Laparoscopic Surgery

基　　金：宁波市消化系统肿瘤临床医学研究中心(2019A21003)。

摘　　要：目的:探讨腹腔镜胰腺颈部切除术的相关经验。方法:回顾分析2017年9月至2022年11月为21例患者行腹腔镜胰腺中段切除术的围手术期资料,并总结经验。结果:21例手术均顺利完成,术中输血1例,胆道造影2例,采用荧光腹腔镜辅助4例。手术时间平均(314.8±126.6)min,估计术中出血量180.9(75,200)mL。术后病理证实导管内黏液性乳头状瘤5例、浆液性囊腺瘤6例、黏液性囊腺瘤3例、实性假乳头状瘤3例、神经内分泌瘤3例、导管腺癌1例。术后未发生胆总管狭窄、胆漏;发生生化漏4例,B级胰瘘15例,C级胰瘘2例。结论:腹腔镜胰腺中段切除术作为胰腺功能保全的手术,具有一定的手术风险且术后胰瘘发生率较高,应由具备丰富手术经验的外科医生施术。Objective:To investigate the experience of laparoscopic central pancreatectomy.Methods:The perioperative data of 21 patients who underwent laparoscopic central pancreatectomy were retrospectively analyzed from Sep.2017 to Nov.2022.According these data,the treatment experience of pancreatic neck resection were summarized.Results:All the laparoscopic operations were s uccessfully completed,1 case got intraoperative blood transfusion,2 cases underwent intraoperative cholangiography and 4 cases were a ssisted by intraoperative fluorescent laparoscopy.The time of surgery was(314.8±126.6)min,and the estimated intraoperative bleeding volume was 180.9(75,200)mL.Postoperative pathology confirmed 5 cases of intraductal mucinous papillary neoplasm,6 cases of serous cystadenoma,3 cases of mucinous cystadenoma,3 cases of solid pseudopapillary neoplasms,3 cases of neuroendocrine tumor and 1 case of pancreatic ductal adenocarcinoma.There were no postoperative common bile duct stenosis and bile leakage.Among them,there were 4 cases of biochemical leakage,15 cases of grade B pancreatic fistula,and 2 cases of grade C pancreatic fistula.Conclusions:Laparoscopic pancreatic neck resection,as a procedure for preserving pancreatic function,has certain surgical risks and a high probability of postope-rative pancreatic fistula,and should be carried out by experienced surgeons.

关 键 词：胰腺肿瘤 胰腺中段切除术 腹腔镜检查 

分 类 号：R735.9[医药卫生—肿瘤]