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腹腔镜辅助与开放保留幽门胰十二指肠切除术治疗壶腹周围疾病的比较。

Comparison of laparoscopy-assisted and open pylorus-preserving pancreaticoduodenectomy for periampullary disease.

作者信息

Cho Akihiro, Yamamoto Hiroshi, Nagata Matsuo, Takiguchi Nobuhiro, Shimada Hideaki, Kainuma Osamu, Souda Hiroaki, Gunji Hisashi, Miyazaki Akinari, Ikeda Atsushi, Tohma Tomoko, Matsumoto Ikuko

机构信息

Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, Chiba, Japan.

出版信息

Am J Surg. 2009 Sep;198(3):445-9. doi: 10.1016/j.amjsurg.2008.12.025. Epub 2009 Apr 1.

Abstract

BACKGROUND

Although many reports have described laparoscopic pancreatic surgery, pancreaticoduodenectomy (PD) has not been widely accepted. The present study aimed to compare laparoscopy-assisted and open pylorus-preserving pancreaticoduodenectomy (PPPD) to investigate the feasibility, safety, and tumor clearance.

METHODS

Fifteen patients with periampullary disease underwent laparoscopy-assisted PPPD, in which resection was performed laparoscopically and the reconstruction was performed through a small midline incision. These patients were compared with 15 patients who, during the same period, underwent conventional open PPPD.

RESULTS

Mean operative time and mean blood loss were similar between groups. No significant differences in the incidence of complications or hospital stay were noted between groups. Surgical margin and number of lymph nodes found in the resected specimen did not differ between groups.

CONCLUSIONS

Laparoscopy-assisted PPPD is on the same level with conventional open surgery in terms of perioperative outcomes or treatment efficacy.

摘要

背景

尽管许多报告描述了腹腔镜胰腺手术,但胰十二指肠切除术(PD)尚未被广泛接受。本研究旨在比较腹腔镜辅助与开放保留幽门胰十二指肠切除术(PPPD),以探讨其可行性、安全性和肿瘤清除情况。

方法

15例壶腹周围疾病患者接受了腹腔镜辅助PPPD,其中切除通过腹腔镜进行,重建通过小中线切口进行。将这些患者与同期接受传统开放PPPD的15例患者进行比较。

结果

两组的平均手术时间和平均失血量相似。两组在并发症发生率或住院时间方面无显著差异。切除标本中的手术切缘和发现的淋巴结数量在两组之间无差异。

结论

腹腔镜辅助PPPD在围手术期结果或治疗效果方面与传统开放手术处于同一水平。

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