Jin W W, Xu X W, Mou Y P, Zhou Y C, Zhang R C, Yan J F, Zhou J Y, Huang C J, Lu C
Department of Gastro-entero-pancreatic, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Zhonghua Wai Ke Za Zhi. 2017 May 1;55(5):354-358. doi: 10.3760/cma.j.issn.0529-5815.2017.05.009.
To summary the experience of 233 cases of laparoscopic pancreaticoduodenectomy (LPD) performed by a single surgical team. Data of patients undergoing LPD from September 2012 to October 2016 were reviewed. There were 145 males and 88 females with the mean age of(60.3±13.0)years old, ranging from 19 to 92 years old, and the mean body mass index of (22.8±3.5)kg/m(2,) ranging from 16.3 to 36.8 kg/m(2). There were 195 patients with clinical manifestation and 54 patients who had the history of abdominal surgery. LPD were performed on 233 patients by same surgical team consecutively. The mean operative time was(368.0±57.4)minutes. Mean blood loss was(203.8±138.6)ml. The postoperative morbidity rate was 33.5%, with 6.9% of grade B or C pancreatic fistula and 9.9% of bleeding. The reoperation rate was 5.6%. The mortality during 30 days after operation was 0.9%. Mean postoperative hospital stay was (18.1±11.2)days. Mean tumor size was (3.9±2.4)cm, and the mean number of lymph nodes harvested was 21.3±11.9.One hundred and sixty-three patients were diagnosed as malignant tumor, including pancreatic adenocarcinoma(=84), cholangiocarcinoma(=17), ampullary adenocarcinoma(=55), duodenal adenocarcinoma(=5), gastric cancer(=1)and duel cancer (=1) located in distal stomach and duodenum. The key point to make laparoscopic pancreaticduodenectomy a routine safe procedure is to operate the procedure under skilled hands in selected patients via suitable surgical approaches.
总结由单一手术团队实施的233例腹腔镜胰十二指肠切除术(LPD)的经验。回顾了2012年9月至2016年10月接受LPD手术患者的数据。其中男性145例,女性88例,平均年龄(60.3±13.0)岁,年龄范围为19至92岁,平均体重指数为(22.8±3.5)kg/m²,范围为16.3至36.8 kg/m²。有195例患者有临床表现,54例患者有腹部手术史。同一手术团队连续对233例患者实施了LPD。平均手术时间为(368.0±57.4)分钟。平均失血量为(203.8±138.6)ml。术后并发症发生率为33.5%,B级或C级胰瘘发生率为6.9%,出血发生率为9.9%。再次手术率为5.6%。术后30天内死亡率为0.9%。平均术后住院时间为(18.1±11.2)天。平均肿瘤大小为(3.9±2.4)cm,平均清扫淋巴结数目为21.3±11.9。163例患者被诊断为恶性肿瘤,包括胰腺腺癌(=84)、胆管癌(=17)、壶腹腺癌(=55)、十二指肠腺癌(=5)、胃癌(=1)以及位于胃远端和十二指肠的双原发癌(=1)。使腹腔镜胰十二指肠切除术成为常规安全手术的关键在于,通过合适的手术入路,由技术熟练的医生在经过挑选的患者身上实施该手术。