Shirai Yoshihiro, Shiba Hiroaki, Horiuchi Takashi, Saito Nobuhiro, Furukawa Kenei, Sakamoto Taro, Gocho Takeshi, Ishida Yuichi, Yanaga Katsuhiko
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2016 Jul;36(7):3505-10.
BACKGROUND/AIM: Pancreaticoduodenectomy (PD) is one of the most complicated procedures. We retrospectively assessed the therapeutic outcome after PD by Junior surgeons.
This study included 253 patients. We retrospectively analyzed surgical outcomes and long-term survivals of PDs performed by Junior surgeons (surgical training year within 10 years) as compared to those by Senior surgeons (surgical training year over 10 years).
Operative time was significantly longer in junior surgeons than that in Senior surgeons (p<0.001). Intraoperative blood loss (p=0.079), hospital stay (p=0.803), complications (p=0.700), mortality (p=0.442) were comparable between the two groups. Disease-free and overall survival rates were not statistically different between the two groups in pancreatic cancer (p=0.248 and p=0.526) and in bile duct or ampullary cancer (p=0.873 and p=0.954).
PD performed by Junior surgeons require approximately 70 more minutes but surgery can be performed safely under appropriate patient selection, intraoperative supervision and perioperative management with comparable long-term survival.
背景/目的：胰十二指肠切除术（PD）是最复杂的手术之一。我们回顾性评估了初级外科医生实施PD后的治疗效果。
本研究纳入253例患者。我们回顾性分析了初级外科医生（手术培训年限在10年以内）与高级外科医生（手术培训年限超过10年）实施PD的手术结果和长期生存率。
初级外科医生的手术时间显著长于高级外科医生（p<0.001）。两组之间的术中失血量（p=0.079）、住院时间（p=0.803）、并发症（p=0.700）、死亡率（p=0.442）相当。在胰腺癌患者中，两组的无病生存率和总生存率无统计学差异（p=0.248和p=0.526）；在胆管癌或壶腹癌患者中，两组的无病生存率和总生存率也无统计学差异（p=0.873和p=0.954）。
初级外科医生实施PD手术所需时间大约多70分钟，但在适当的患者选择、术中监督和围手术期管理下，可以安全地进行手术，且长期生存率相当。
