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14例腹腔镜胰十二指肠切除术及消化道重建术并发症发生率最低的成功经验报告

Successful Experience of Laparoscopic Pancreaticoduodenectomy and Digestive Tract Reconstruction With Minimized Complications Rate by 14 Case Reports.

作者信息

Fan Yong, Zhao Yanhui, Pang Lan, Kang Yingxing, Kang Boxiong, Liu Yongyong, Fu Jie, Xia Bowei, Wang Chen, Zhang Youcheng

机构信息

From the Minimally Invasive Surgery Center, The Second Hospital of Lanzhou University, Lanzhou, Gansu Province, China.

出版信息

Medicine (Baltimore). 2016 Apr;95(17):e3167. doi: 10.1097/MD.0000000000003167.

Abstract

Laparoscopic pancreatic surgery is one of the most sophisticated and advanced applications of laparoscopy in the current surgical practice. The adoption of laparoscopic pancreaticoduodenectomy (LPD) has been relatively slow due to the technical challenges. The aim of this study is to review and characterize our successful LPD experiences in patients with distal bile duct carcinoma, periampullary adenocarcinoma, pancreas head cancer, and duodenal cancer and evaluate the clinical outcomes of LPD for its potential in oncologic surgery applications.We retrospectively analyzed the clinical data from 14 patients who underwent LPD from August 2013 to February 2015 in our institute.We presented our LPD experience with no cases converted to open surgery in all 14 cases, which included 10 cases of laparoscopic digestive tract reconstruction and 4 cases of open digestive tract reconstructions. There were no deaths during the perioperative period and no case of gastric emptying disorder or postoperative bleeding. The other clinical indexes were comparable to or better than open surgery.Based on our experience, LPD could be potentially safe and feasible for the treatment of early pancreas head cancer, distal bile duct carcinoma, periampullary adenocarcinoma, and duodenal cancer. The master of LPD procedure requires technical expertise but it can be accomplished with a short learning curve.

摘要

腹腔镜胰腺手术是当前外科实践中腹腔镜技术最复杂、最先进的应用之一。由于技术挑战,腹腔镜胰十二指肠切除术(LPD)的采用相对缓慢。本研究的目的是回顾并描述我们在远端胆管癌、壶腹周围腺癌、胰头癌和十二指肠癌患者中成功实施LPD的经验,并评估LPD在肿瘤外科手术应用中的临床结局及其潜力。我们回顾性分析了2013年8月至2015年2月在我院接受LPD的14例患者的临床资料。我们介绍了我们的LPD经验,14例患者均未中转开腹手术,其中包括10例腹腔镜消化道重建和4例开放消化道重建。围手术期无死亡病例,无胃排空障碍或术后出血病例。其他临床指标与开放手术相当或优于开放手术。根据我们的经验,LPD对于早期胰头癌、远端胆管癌、壶腹周围腺癌和十二指肠癌的治疗可能是安全可行的。掌握LPD手术需要技术专长,但学习曲线较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9661/4998677/8f2cc0d670c0/medi-95-e3167-g002.jpg

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