腹腔镜三孔胰体尾切除术。
Laparoscopic three-port distal pancreatectomy.
机构信息
Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA.
出版信息
HPB (Oxford). 2011 May;13(5):361-3. doi: 10.1111/j.1477-2574.2011.00297.x. Epub 2011 Mar 22.
AIMS
Laparoscopic distal pancreatectomy is becoming a more commonly used procedure, which may involve the use of four to seven ports, depending on the technique. Initial data on feasibility, safety and outcome with the three-port laparoscopic distal pancreatectomy are presented.
METHODS
The patient is placed in a partial thoracoabdominal position exposing the left flank in a reverse Trendelenberg position. A 10-mm Hassan trocar is inserted through a subcostal anterior axillary incision. A 5-mm midclavicular and 10-mm posterior axillary line trocar are placed. The specimen is retrieved from the anterior axillary line port.
RESULTS
Ten women and seven men, aged 26-88 years (mean 61 years), were evaluated. Their body mass indexes ranged from 18-37 (mean 27). Pancreatic lesion size ranged from 1.0-5.5 cm (mean 3.0 cm). Operative time was 116-296 min (mean 170 min). Blood loss was 10-300 ml (mean 142 ml). No operation required conversion or additional trocar placement. Post-operative stay was 2-7 days (mean 4 days). No patient developed a pancreatic fistula.
CONCLUSION
Operative time, blood loss and post-operative stay of this three-port technique compare favourably with published data.
目的
腹腔镜胰体尾切除术已成为一种更为常用的手术方式，其可能需要使用 4 至 7 个端口，具体取决于手术技术。本文介绍了三孔法腹腔镜胰体尾切除术的可行性、安全性和初步结果。
方法
患者取半侧胸腹位，左侧肋缘下做反向特伦德伦伯格体位。于前腋前线肋缘下置入 10mm Hassan 戳卡，锁骨中线及腋后线分别置入 5mm 及 10mm 戳卡。标本由腋前线切口取出。
结果
共纳入 10 例女性和 7 例男性患者，年龄 26-88 岁（平均 61 岁），体重指数 18-37（平均 27），胰腺病变大小 1.0-5.5cm（平均 3.0cm）。手术时间 116-296min（平均 170min），术中出血量 10-300ml（平均 142ml），无中转开腹及附加切口，术后住院时间 2-7 天（平均 4 天）。无胰瘘发生。
结论
与文献报道相比，三孔法腹腔镜胰体尾切除术的手术时间、术中出血量和术后住院时间具有优势。
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