Department of GI and HPB Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Dig Surg. 2010 Aug;27(3):175-81. doi: 10.1159/000264674. Epub 2010 Jun 22.
Few studies describing the use of stapling devices for uncinate process division during pancreaticoduodenectomy (PD) have data regarding outcomes. Our aim is to discuss our technique and the peri-operative outcomes with the use of the linear vascular stapler for division of the uncinate process during PD.
19 consecutive patients who underwent stapler division of the uncinate process ('stapler' group) were compared to 20 consecutive patients operated without stapler ('no-stapler' group).
The overall surgical morbidity in the no-stapler group was 25% (5/20) and 31.6% (6/19) in the stapler group (p = 0.731). The mean blood loss in the no-stapler group was 1,077.5 +/- 594 ml compared to 778 +/- 302 ml in the stapler group (p = 0.113). The mean operative duration was 498 +/- 105 min in the no-stapler group and 490 +/- 60 min in the stapler group (p = 0.773). The average number of lymph nodes retrieved was 6.1 +/- 3 in the no-stapler group versus 5.9 +/- 4 in the stapler group (p = 0.627). Neither group had positive resection margins.
Stapler division of the uncinate process for selected periampullary tumours compares well with the conventional method, has comparable peri-operative outcomes without compromising oncological radicality and has the potential to simplify uncinate resection.
很少有研究描述在胰十二指肠切除术（PD）中使用吻合器分离钩突过程的数据。我们的目的是讨论使用线性血管吻合器分离钩突过程的技术和围手术期结果。
19 例连续接受吻合器钩突切除术的患者（“吻合器”组）与 20 例连续接受无吻合器手术的患者（“无吻合器”组）进行比较。
无吻合器组的总体手术发病率为 25%（5/20），吻合器组为 31.6%（6/19）（p = 0.731）。无吻合器组的平均出血量为 1077.5 ± 594 ml，而吻合器组为 778 ± 302 ml（p = 0.113）。无吻合器组的平均手术时间为 498 ± 105 min，而吻合器组为 490 ± 60 min（p = 0.773）。无吻合器组平均检出淋巴结数为 6.1 ± 3 个，而吻合器组为 5.9 ± 4 个（p = 0.627）。两组均无阳性切缘。
对于选定的壶腹周围肿瘤，吻合器分离钩突与传统方法相比效果良好，具有相似的围手术期结果，而不会影响肿瘤根治性，并具有简化钩突切除术的潜力。
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