Wang S P, Liu S Y, Zhang W, Wang Y C, Ji B, Meng L Y, Liu Y H
Secondary Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Jilin University, Changchun 130021, China.
Zhonghua Yi Xue Za Zhi. 2020 Nov 17;100(42):3328-3331. doi: 10.3760/cma.j.cn112137-20200316-00789.
To explore the value of "posterior approach, uncinate process priority, artery first" in laparoscopic pancreatoduodenectomy. The clinical data of 200 patients who underwent laparoscopic pancreatoduodenectomy from January 2018 to April 2019 in the Second Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Jilin University were analyzed retrospectively. Meanwhile, the advantages of "posterior approach, uncinate process priority, artery first" were analyzed. Two hundred patients were treated with "posterior approach, uncinate process priority, artery first". The average total operation time was (260.2±50.1) min, sample cutting time was (86.6±18.7) min, intraoperative bleeding volume was 50 (50-100) ml, average number of lymph node dissection was (19.2±7.4), and average hospitalization time was (17.9±9.9) days. The "posterior approach, uncinate process first, artery first" approach not only protects the variant hepatic artery, but also allows early detection of SMA, clarifies the positional relationship between the tumor and SMA, realizes R0 resection, and reduces the amount of bleeding during operation and shortens the operation time, which is safe and feasible in clinical setting.
探讨“后入路、钩突优先、动脉优先”在腹腔镜胰十二指肠切除术中的应用价值。回顾性分析吉林大学第一医院肝胆胰外科二病区2018年1月至2019年4月行腹腔镜胰十二指肠切除术的200例患者的临床资料。同时,分析“后入路、钩突优先、动脉优先”的优势。200例患者采用“后入路、钩突优先、动脉优先”治疗。平均总手术时间为(260.2±50.1)分钟,标本切断时间为(86.6±18.7)分钟,术中出血量为50(50 - 100)毫升,平均清扫淋巴结数为(19.2±7.4)枚,平均住院时间为(17.9±9.9)天。“后入路、钩突优先、动脉优先”的手术方式不仅能保护变异肝动脉,还能早期发现肠系膜上动脉,明确肿瘤与肠系膜上动脉的位置关系,实现R0切除,减少术中出血量,缩短手术时间,在临床应用中安全可行。