腹腔镜胰十二指肠切除术的学习曲线:一位外科医生对连续患者的经验

Learning Curve for Laparoscopic Pancreaticoduodenectomy: A Single Surgeon's Experience with Consecutive Patients.

作者信息

Kuroki Tamotsu, Kitasato Amane, Adachi Tomohiko, Tanaka Takayuki, Hirabaru Masataka, Matsushima Hajime, Soyama Akihiko, Hidaka Masaaki, Takatsuki Mitsuhisa, Eguchi Susumu

出版信息

Hepatogastroenterology. 2014 May;61(131):838-41.

DOI:
Abstract

BACKGROUND/AIMS: Laparoscopic pancreaticoduodenectomy (LPD) is regarded as one of the most complex surgical procedures. The aim of this study was to examine a single surgeon's learning curve for LPD in consecutive cases.

METHODOLOGY

Thirty consecutive patients who underwent an LPD by the same single surgeon were divided into three groups (A, B, and C; 10 cases each). Postoperative complications, operative time, and blood loss for each group were compared.

RESULTS

There were no significant differences in the occurrence of postoperative complications among the groups. There were significant differences in both operative time and blood loss between groupA (mean operative time, 796.8 mm; mean blood loss 546.2 mL) and group B (mean operative time, 563.9 mm; mean blood loss 242.0 mL), and between groups A and C (mean operative time, 515.8 mm; mean blood loss 283.0 mL). Regarding operative time and blood loss, the surgeon reached a learning curve plateau after 10 cases/LPD procedures.

CONCLUSIONS

LPD is a feasible and safe surgical procedure with a steep learning curve when performed by a surgeon who is experience in open PD, and LPD provides the advantages that would be expected from a minimally invasive surgery.

摘要

背景/目的:腹腔镜胰十二指肠切除术(LPD)被认为是最复杂的外科手术之一。本研究的目的是在连续病例中检验单一外科医生进行LPD的学习曲线。

方法

由同一位单一外科医生进行LPD的30例连续患者被分为三组(A组、B组和C组;每组10例)。比较每组的术后并发症、手术时间和失血量。

结果

各组之间术后并发症的发生率无显著差异。A组(平均手术时间796.8分钟;平均失血量546.2毫升)与B组(平均手术时间563.9分钟;平均失血量242.0毫升)之间以及A组与C组(平均手术时间515.8分钟;平均失血量283.0毫升)之间的手术时间和失血量均有显著差异。关于手术时间和失血量,该外科医生在完成10例/LPD手术后达到了学习曲线平台期。

结论

对于有开放胰十二指肠切除术经验的外科医生而言,LPD是一种可行且安全的手术,但学习曲线较陡,且LPD具有微创手术预期的优势。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索