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腹腔镜手术治疗胰腺胰岛素瘤

[Surgical treatment of pancreatic insulinoma by laparoscopy].

作者信息

Dai Meng-hua, Zhao Yu-pei, Liao Quan, Liu Zi-wen, Hu Ya, Guo Jun-chao

机构信息

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 Feb 1;44(3):165-8.

Abstract

OBJECTIVE

To evaluate the safety and outcome of laparoscopic insulinoma resection.

METHODS

Twenty-five patients with insulinoma were admitted and divided into two groups: laparoscopic group (10 patients) and laparotomy group (15 patients). All tumors of two groups were located at the body or tail of pancreas preoperatively by abdominal CT and digital subtraction angiography (DSA). Laparoscopic enucleation was performed for patients in laparoscopic group, open enucleation was performed for patients in laparotomy group. There were no differences in preoperative location and size of tumors between two groups. Statistical method was used to compare the discrepancy from operation time, the volume of blood loss, hospital stay and morbidity of complication between two groups.

RESULTS

There were no discrepancies from operation time, blood loss, hospital stay after operation between two groups (P > 0.05). However, one case of pancreatic leakage developed in laparoscopic group, comparably, 3 cases of pancreatic leakage, 2 cases of celiac sepsis and 5 cases of fluid accumulation in thoracic cavity developed in laparotomy group. There were significant discrepancies in morbidity of complication between two groups.

CONCLUSIONS

Laparoscopic resection of pancreatic insulinoma is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.

摘要

目的

评估腹腔镜胰岛素瘤切除术的安全性及疗效。

方法

收治25例胰岛素瘤患者,分为两组:腹腔镜组(10例)和开腹手术组(15例)。两组患者术前均经腹部CT及数字减影血管造影(DSA)检查确定肿瘤位于胰腺体尾部。腹腔镜组患者行腹腔镜下肿瘤剜除术,开腹手术组患者行开腹肿瘤剜除术。两组患者术前肿瘤位置及大小无差异。采用统计学方法比较两组患者手术时间、出血量、住院时间及并发症发生率的差异。

结果

两组患者手术时间、出血量、术后住院时间差异无统计学意义(P>0.05)。然而,腹腔镜组发生1例胰漏,相比之下,开腹手术组发生3例胰漏、2例腹腔感染及5例胸腔积液。两组并发症发生率差异有统计学意义。

结论

腹腔镜切除位于胰腺体尾部的胰岛素瘤安全可行。其应用于位于胰头部的肿瘤需进一步评估。

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