12例腹腔镜下保留十二指肠胰头切除术的临床回顾与分析  

Clinical review and analysis of laparoscopic duodenum-preserving pancreatic head resection for 12 cases

作　　者：代龙翱 魏东[1] 唐波[1] 邹仁超 王秋虹[1] 王槐志 DAI Longao;WEI Dong;TANG Bo;ZOU Renchao;WANG Qiuhong;WANG Huaizhi(Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital of Kunming Medical University,Kunming 650000,P.R.China;Institute of Hepatopancreatobiliary Surgery,Chongqing General Hospital,Chongqing University,Chongqing 401147,P.R.China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科,昆明650000 [2]重庆大学附属人民医院(重庆市人民医院)肝胆胰腺外科研究所,重庆401147

出　　处：《中国普外基础与临床杂志》2025年第2期169-174,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：昆明医科大学第二附属医院院内临床研究项目(项目编号:ynIIT2023008);昆明医科大学第二附属医院对外合作研究基金资助项目(项目编号:2022dwhz05)。

摘　　要：目的总结腹腔镜下保留十二指肠的胰头切除术(laparoscopic duodenum-preserving pancreatic head resection,LDPPHR)治疗胰头良性病变的临床效果及经验。方法回顾性分析2020年1月至2024年12月期间于昆明医科大学第二附属医院肝胆胰外科行LDPPHR的12例患者的临床资料。结果12例患者均按计划完成LDPPHR。手术时间138~479 min、平均336 min;术中出血量40~700 mL、平均270 mL;住院时间11~51 d,平均21.5 d。术中均未输血。术后发生胰瘘6例(A级胰瘘5例,B级胰瘘1例),胆汁漏2例,胃排空障碍1例;围手术期未出现死亡。术后病理学检查:慢性胰腺炎、主胰管结石8例,导管内乳头状黏液瘤3例,浆液性囊腺瘤1例。术后获访10例,随访时间6~24个月,随访期间均未出现复发,也未发生糖尿病、胃排空障碍等远期并发症。结论LDPPHR具有创伤不大、恢复耗时较短、术后患者生活质量提高等优点,治疗胰头良性病变安全可行。Objective To evaluate and synthesize the available experiences related to laparoscopic duodenumpreserving pancreatic head resection(LDPPHR)in the management of benign pancreatic head lesions.Methods A retrospective review of the clinical data was conducted for 12 patients who underwent LDPPHR at the Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital of Kunming Medical University(between January 2020 and December 2024).Results All 12 patients successfully underwent LDPPHR.The surgical duration ranged from 138 to 479 min,with a mean of 336 min.Intraoperative blood loss varied between 40 and 700 mL,averaging 270 mL.The hospital stay varied from 11 to 51 d,with a mean duration of 21.5 d.Notably,none of the 12 patients required blood transfusions during the procedure.Of the 12 patients,6 were diagnosed with a pancreatic fistula postoperatively,including 5 cases classified as grade A pancreatic fistula,and 1 cases of grade B pancreatic leakage.There were 2 cases of bile leakage and 1 case of gastric emptying disorder.No deaths occurred during the perioperative period.Postoperative pathological examination revealed:chronic pancreatitis witch main pancreatic duct stones in 8 cases,intraductal papillary mucinous neoplasms with low-grade epithelial intraepithelial neoplasia in 3 cases,serous cystadenoma in 1 case.Postoperative follow-up was conducted for 10 patients,with follow-up durations ranging from 6 to 24 months.No recurrence was observed during the follow-up period,and no long-term complications such as diabetes,gastric emptying dysfunction,etc.were reported.Conclusions LDPPHR offers several benefits,including minimal invasiveness,faster recovery,and enhanced postoperative quality of life for patients.It is safe and feasible for the treatment of benign lesions in the head of the pancreas.

关 键 词：腹腔镜下保留十二指肠的胰头切除术 临床效果 术后胰瘘 

分 类 号：R73[医药卫生—肿瘤]