Röthlin M, Schöb O
Klinik für Viszeralchirurgie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1999 May 15;129(19):731-5.
The greater part of patients presenting with pancreatic cancer is irresectable at the time of diagnosis. They are in need of palliative treatment. We report our first experience with a new concept of laparoscopic palliation based on the findings of preoperative imaging and diagnostic laparoscopy. Between 1995 and 1998, 10 patients underwent laparoscopic palliation. In 3 cases laparoscopic double bypass and 7 patients gastroenterostomy was performed, in some instances combined with endoscopic stenting. Postoperative morbidity was 10% for laparoscopic palliation. There was no mortality in laparoscopic bypass surgery. Postoperative hospital stay averaged 11 days. Our preliminary experience strongly suggests that laparoscopic palliation may greatly reduce the three major drawbacks of open bypass surgery, i.e. high morbidity and mortality, and long postoperative hospital stay. Prospective trials in larger study populations will be needed to define the place of this technique in the palliation of pancreatic cancer.
大多数胰腺癌患者在诊断时已无法切除。他们需要姑息治疗。我们根据术前影像学检查和诊断性腹腔镜检查的结果，报告了我们在腹腔镜姑息治疗新概念方面的首次经验。1995年至1998年间，10例患者接受了腹腔镜姑息治疗。3例行腹腔镜双旁路手术，7例行胃肠造口术，部分病例联合内镜支架置入术。腹腔镜姑息治疗的术后发病率为10%。腹腔镜旁路手术无死亡病例。术后平均住院时间为11天。我们的初步经验强烈表明，腹腔镜姑息治疗可能会大大减少开放旁路手术的三大缺点，即高发病率和死亡率以及较长的术后住院时间。需要在更大的研究人群中进行前瞻性试验，以确定该技术在胰腺癌姑息治疗中的地位。
