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腹腔镜下胆总管导管腺癌胰十二指肠切除术:一例报告及文献综述

Laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma of common bile duct: a case report and literature review.

作者信息

Zheng Min-Hua, Feng Bo, Lu Ai-Guo, Li Jian-Wen, Hu Wei-Guo, Wang Ming-Liang, Zang Lu, Dong Feng, Mao Zhi-Hai, Peng Yuan-Fei, Jiang Yu

机构信息

Department of General Surgery, Ruijin Hospital, Shanghai Minimally Invasive Surgery Center, Shanghai Institute of Digestive Surgery, Shanghai Second Medical University, Shanghai, China.

出版信息

Med Sci Monit. 2006 Jun;12(6):CS57-60. Epub 2006 May 29.

Abstract

BACKGROUND

Minimal access techniques have gained wide acceptance in surgical practice, but the role of laparoscopic pancreaticoduodenectomy is still controversial. Laparoscopic pancreaticoduodenectomy has seldom been described. In this report, we assessed the feasibility and safety of laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma of the common bile duct.

CASE REPORT

According to imaging findings, a 71-year-old Chinese man was diagnosed with malignancy of the common bile duct, and successfully underwent laparoscopic pancreaticoduodenectomy in our center. The operation's safety, postoperative recovery, complications, oncological clearance, and short-term follow-up results of the patient are evaluated. No severe intraoperative or postoperative complications were observed. The operation time was 390 minutes, and the blood loss was about 50 ml; the flatus, time to resume early activity and hospital stay were 3, 4, and 30 days respectively. The patient remained well at a follow-up of 6 months.

CONCLUSIONS

Laparoscopic pancreaticoduodenectomy can be performed feasibly and safely by surgeons with advanced laparoscopic skills, and could be considered for the treatment of common bile duct tumors.

摘要

背景

微创技术在外科手术实践中已获得广泛认可,但腹腔镜胰十二指肠切除术的作用仍存在争议。关于腹腔镜胰十二指肠切除术的报道很少。在本报告中,我们评估了腹腔镜胰十二指肠切除术治疗胆总管导管腺癌的可行性和安全性。

病例报告

根据影像学检查结果,一名71岁的中国男性被诊断为胆总管恶性肿瘤,并在我们中心成功接受了腹腔镜胰十二指肠切除术。对该患者手术的安全性、术后恢复情况、并发症、肿瘤切除情况及短期随访结果进行了评估。未观察到严重的术中或术后并发症。手术时间为390分钟,出血量约50毫升;排气时间、恢复早期活动时间和住院时间分别为3天、4天和30天。患者在6个月的随访中情况良好。

结论

具有先进腹腔镜技术的外科医生可以安全、可行地实施腹腔镜胰十二指肠切除术,该手术可考虑用于胆总管肿瘤的治疗。

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