地级市医院32例腹腔镜胰十二指肠切除术经验总结  

Summary of experience in 32 cases of laparoscopic pancreaticoduode-nectomy in prefecture-level city hospitals

作　　者：刘林[1] 谢辉[1] 李晓东[1] 谭煜炜 冯乾 宋思思[1] 麦刚[1] LIU Lin;XIE Hui;LI Xiaodong;TAN Yuwei;FENG Qian;SONG Sisi;MAI Gang(Hepatobiliary and Pancreatic Surgery Department,Deyang People's Hospital,Deyang 618000,China)

机构地区：[1]德阳市人民医院肝胆胰外科,四川德阳618000

出　　处：《临床医学研究与实践》2023年第26期13-16,共4页Clinical Research and Practice

基　　金：四川省科技计划项目(No.2019YFS0043);德阳市科技计划项目(重点研发)(No.2019SZ138,No.2019SZ049)。

摘　　要：目的探讨地级市医院开展腹腔镜胰十二指肠切除术(LPD)的可行性和安全性。方法回顾性分析2017年9月至2022年7月德阳市人民医院收治的32例LPD患者的临床资料,观察其治疗效果,并进行经验总结。结果32例患者的平均手术时间(431.2±142.5)min,平均术中出血量(324.6±165.5)mL,平均术后住院天数(15.2±3.6)d。术后发生B/C级胰瘘4例(12.5%),胆瘘2例(6.2%),胃排空障碍5例(15.6%),出血2例(6.2%),肺部感染2例(6.2%),肠梗阻1例(3.1%)。术后,患者的平均总胆红素、糖链抗原19-9(CA19-9)水平均降低(P<0.05)。结论对于有丰富开腹胰十二指肠切除术(OPD)经验及一定腹腔镜手术操作经验的地级市医院,LPD是一种安全、可行的手术方式。Objective To explore the feasibility and safety of laparoscopic pancreaticoduodenectomy(LPD)in prefecture-level city hospitals.Methods The clinical data of 32 patients with LPD admitted in the Deyang People's Hospital from September 2017 to July 2022 were retrospectively analyzed,the therapeutic effect was observed,and the experience was summarized.Results The mean operation time of the 32 patients was(431.2±142.5)min,the mean intraoperative blood loss was(324.6±165.5)mL,and the mean postoperative hospitalization days was(15.2±3.6)d.There were 4 cases of B/C grade pancreatic fistula(12.5%),2 cases of biliary fistula(6.2%),5 cases of gastric emptying obstruction(15.6%),2 cases of bleeding(6.2%),2 cases of pulmonary infection(6.2%),and 1 case of intestinal obstruction(3.1%)after surgery.After surgery,the levels of mean total bilirubin and carbohyrate antigan 19-9(CA19-9)decreased(P<0.05).Conclusion For prefecture-level city hospitals with rich experience in open pancreaticoduodenectomy(OPD)and certain experience in laparoscopic surgery,LPD is a safe and feasible surgical method.

关 键 词：腹腔镜胰十二指肠切除术 地级市医院 开腹胰十二指肠切除术 

分 类 号：R657.5[医药卫生—外科学]