为一名92岁中国老年患者行腹腔镜胰十二指肠切除术治疗胰头癌：病例报告
Laparoscopic pancreaticoduodenectomy in A-92-older Chinese patient for cancer of head of the pancreas: A Case report.
作者信息
Zhou Jiayu, Xin Chang, Xia Tao, Mou Yiping, Xu Xiaowu, Zhang Renchao, Zhou Yucheng, Jin Weiwei, Lu Chao
机构信息
Department of General Surgery, School of Medicine, Zhejiang University Department of General Surgery, Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, Hangzhou Department of Hepatobiliary Surgery, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang Province, China.
出版信息
Medicine (Baltimore). 2017 Jan;96(3):e5962. doi: 10.1097/MD.0000000000005962.
INTRODUCTION
Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex gastrointestinal procedures performed in laparoscopic abdominal surgery. However, the concern for elderly undergoing LPD remains. To the best of our knowledge, there are no reports describing LPD for A-92-older patient. This study aimed to share the experience of a tertiary pancreatic center and confirm the safety, feasibility of LPD for the elderly.
METHOD
The patient had complained of 6-months history of abdominal discomfort and progressive jaundice. Abdominal computed tomography CT/MR imaging revealed a 3 × 3 cm solid hypovascular mass in the head of the pancreas. LPD was successfully performed after multidisciplinary team (MDT). Operation time was 450 minutes, and blood loss was 120 mL. Histological examination of the resected specimen confirmed the diagnosis of pancreatic ductal adenocarcinoma (PDAC).
OUTCOMES
The patient was discharged on POD13 following an uneventful postoperative period. She was followed up 4 months without any sign of recurrence.
CONCLUSION
LPD can be performed safely in patients of any age who are fit for surgery in specialist centers.
引言
腹腔镜胰十二指肠切除术（LPD）是腹腔镜腹部手术中最复杂的胃肠道手术之一。然而，对于接受LPD的老年人的担忧仍然存在。据我们所知，尚无关于92岁以上患者进行LPD的报道。本研究旨在分享一家三级胰腺中心的经验，并证实LPD对老年人的安全性和可行性。
方法
患者主诉有6个月的腹部不适和进行性黄疸病史。腹部计算机断层扫描CT/MR成像显示胰腺头部有一个3×3 cm的实性低血供肿块。在多学科团队（MDT）评估后成功进行了LPD。手术时间为450分钟，失血120 mL。切除标本的组织学检查确诊为胰腺导管腺癌（PDAC）。
结果
患者术后恢复顺利，于术后第13天出院。随访4个月，无任何复发迹象。
结论
在专科中心，适合手术的任何年龄患者都可以安全地进行LPD。
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