腹腔镜下保留十二指肠的全胰头膜内切除术:同济经验  

Intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection:Tongji Hospital experience

作　　者：徐盟 乔梁[1] 袁天 朱峰[1] XU Meng;QIAO Liang;YUAN Tian;ZHU Feng(Department of Biliary-Pancreatic Surgery,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,P.R.China)

机构地区：[1]华中科技大学同济医学院附属同济医院胆胰外科,武汉430030

出　　处：《中国普外基础与临床杂志》2025年第2期163-168,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金面上项目(项目编号:81874205)。

摘　　要：目的探讨腹腔镜下保留十二指肠的全胰头膜内切除术的临床疗效并总结经验。方法回顾性收集2020年4月至2024年6月期间在华中科技大学同济医学院附属同济医院胆胰外科接受腹腔镜下保留十二指肠的全胰头膜内切除术的75例患者的临床资料,分析患者术前、术中及术后情况。结果75例患者中男35例(46.7%),女40例(53.3%);年龄(38.3±7.9)岁;无症状患者35例(46.7%),主要症状表现为腹痛(21例,28.0%)、腹泻(15例,20.0%)、体质量减轻(4例,5.3%);病变直径(3.2±0.8)cm。手术时间(210.6±23.8)min,术中出血量(62.4±38.1)mL。术后发生并发症18例(24.0%),其中B级胰瘘6例(8.0%)、术后出血5例(6.7%)、胆瘘4例(5.3%)、乳糜瘘2例(2.7%)、术后胃排空延迟4例(5.3%)、腹腔感染2例(2.7%)、肺部感染1例(1.3%)、切口感染2例(2.7%)。术后住院时间(11.7±3.3)d,无术后90 d内死亡病例。结论对于胰头部良性、交界性以及低度恶性肿瘤性病变患者,腹腔镜下保留十二指肠的全胰头膜内切除术是安全可行的。Objective To explore the clinical efficacy and summarize the experience of intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection(LDPPHRt).Method The clinical data of patients(from April 2020 to June 2024),including preoperative,intraoperative,and postoperative details who underwent LDPPHRt in Department of Biliary-Pancreatic Surgery,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were collected and analyzed.Results Seventy-five patients were collected in this study,including 35 males(46.7%)and 40 females(53.3%).The age was(38.3±7.9)years old,and 35 patients(46.7%)presented without symptoms.The main symptoms were abdominal pain(21 cases,28.0%),repeated diarrhea(15 cases,20.0%),weight loss(4 cases,5.3%).The diameter of the pancreatic head lesions was(3.2±0.8)cm.The operative time was(210.6±23.8)min,and the blood loss was(62.4±38.1)mL.There were 18 cases(24.0%)of postoperative complications,including 6 cases(8.0%)of postoperative pancreatic fistula,5 cases(6.7%)of haemorrhage,4 cases(5.3%)of biliary leakage,2 cases(2.7%)of lymphatic leakage,4 cases(5.3%)of delayed gastric emptying,2 cases(2.7%)of abdominal infection,1 case(1.3%)of pulmonary infection and 2 cases(2.7%)of wound infection.The length of postoperative hospital stay was(11.7±3.3)d,and no one died within 90 d after surgery.Conclusions The intracapsular approach is a feasible and safe surgical procedure in LDPPHRt for patients with benign,borderline or low grade malignant tumors.

关 键 词：腹腔镜下保留十二指肠的全胰头膜内切除术 保留十二指肠的胰头切除术 手术效果 

分 类 号：R657.5[医药卫生—外科学]