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两家中型医疗中心的腹腔镜胰腺切除术

Laparoscopic pancreatic resections in two medium-sized medical centres.

作者信息

Baiocchi Gian Luca, Rosso Edoardo, Celotti Andrea, Zimmiti Giuseppe, Manzoni Alberto, Garatti Marco, Tiberio Guido, Portolani Nazario

机构信息

Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.

UOC Chirurgia Generale, Fondazione Poliambulanza, Brescia, Italy.

出版信息

Updates Surg. 2018 Mar;70(1):41-45. doi: 10.1007/s13304-018-0520-x. Epub 2018 Feb 28.

Abstract

To analyze the clinical outcomes of patients undergoing minimally invasive surgery for pancreatic neoplasms, in two medium-volume centers in Northern Italy, a retrospective chart review was performed in the operative registries, searching for patients who had undergone pancreatic surgery via laparoscopy, irrespective of the final pathological nature of the resected neoplasm. For each case, a standard data extraction form was completed and the following data was extracted: age and sex, type of resection, estimated blood loss, length of the operation, number of harvested nodes, post-operative pancreatic fistula, major post-operative complications, mortality and final pathological diagnosis. The systematic literature research was also undertaken and the reported results were analyzed. A total of 55 cases were recorded, including 39 distal pancreatectomies and 16 pancreaticoduodenectomies. The most frequent indications leading to surgery were ductal adenocarcinoma (26 pts) and cystic neoplasm (22 pts). No post-operative death occurred in this series; pancreatic fistula occurred in 64% of distal pancreatectomies and 22% of pancreaticoduodenectomies. The mean operating times were 178' and 572', respectively. Both distal pancreatectomy and pancreaticoduodenectomy proved to be feasible and were safely performed by laparoscopy, in two centers with medium-volume pancreatic caseload.

摘要

为分析在意大利北部两个中等规模中心接受胰腺肿瘤微创手术患者的临床结局,我们对手术登记处进行了回顾性病历审查,寻找通过腹腔镜进行胰腺手术的患者,无论切除肿瘤的最终病理性质如何。对于每个病例,我们填写了标准的数据提取表,并提取了以下数据:年龄和性别、切除类型、估计失血量、手术时长、获取的淋巴结数量、术后胰瘘、主要术后并发症、死亡率和最终病理诊断。我们还进行了系统的文献研究并分析了报告的结果。共记录了55例病例,包括39例远端胰腺切除术和16例胰十二指肠切除术。导致手术的最常见指征是导管腺癌(26例)和囊性肿瘤(22例)。本系列中无术后死亡发生;胰瘘在远端胰腺切除术中发生率为64%,在胰十二指肠切除术中发生率为22%。平均手术时间分别为178分钟和572分钟。在两个胰腺病例数量中等的中心,远端胰腺切除术和胰十二指肠切除术均被证明是可行的,并且可以通过腹腔镜安全地进行。

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