腹腔镜胰十二指肠切除术改良胰肠吻合技术的临床应用。

Clinical application of a modified pancreatojejunostomy technique for laparoscopic pancreaticoduodenectomy.

机构信息

Department of Pancreatic Surgery, First Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, PR China.

出版信息

HPB (Oxford). 2019 Oct;21(10):1336-1343. doi: 10.1016/j.hpb.2019.02.006. Epub 2019 Mar 2.

DOI:10.1016/j.hpb.2019.02.006

PMID:30833188

Abstract

BACKGROUND

The aim of this study was to present a modified pancreatojejunostomy technique for laparoscopic pancreaticoduodenectomy (LPD) and to evaluate its safety and reliability.

METHODS

Clinical data from 67 patients who underwent LPD at a single center, from September 2016 to December 2017 were retrospectively collected and analysed. Of these patients, 31 cases were subjected to modified pancreatojejunostomy (modified group), and 36 cases received duct-to-mucosa pancreatojejunostomy (control group) for LPD. We compared and analysed the operative outcomes and postoperative complications between the patients in the two groups.

RESULTS

All LPDs were successfully completed. The mean operation time for pancreatojejunostomy in the modified group was obviously lower than that of the control group (30.9 ± 6.6 min vs 45.3 ± 6.1 min, P < 0.01), and the total operative time was also shorter (321.8 ± 63.6 min vs 362.2 ± 59.6 min, P < 0.05) in the modified group. The overall incidence of postoperative complications was similar (29.0% vs 30.6% P = 0.724). Clinically relevant grade B/C POPF occurred in 2 patients (6.5%) in the modified group and 3 patients (8.3%) in the control group (P = 0.947); All cases were cured using conservative treatment.

CONCLUSIONS

Our modified pancreatojejunostomy technique is safe, effective and easy to manipulate and learn following LPD.

摘要

背景

本研究旨在介绍一种腹腔镜胰十二指肠切除术（LPD）改良胰肠吻合术技术，并评估其安全性和可靠性。

方法

回顾性收集 2016 年 9 月至 2017 年 12 月在单中心行 LPD 的 67 例患者的临床资料并进行分析。其中 31 例行改良胰肠吻合术（改良组），36 例行胰管黏膜吻合术（对照组）。比较并分析两组患者的手术结果和术后并发症。

结果

所有 LPD 均顺利完成。改良组胰肠吻合时间明显短于对照组（30.9±6.6 min vs 45.3±6.1 min，P<0.01），总手术时间也较短（321.8±63.6 min vs 362.2±59.6 min，P<0.05）。改良组术后总体并发症发生率与对照组相似（29.0% vs 30.6%，P=0.724）。改良组发生 2 例（6.5%）临床相关 B/C 级 POPF，对照组发生 3 例（8.3%）（P=0.947）；所有病例均采用保守治疗治愈。