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腹腔镜胰腺肿瘤剜除术:单中心 66 例经验总结。

Laparoscopic enucleation of pancreatic tumours: a single-institution experience of 66 cases.

机构信息

School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Pancreatic Surgery, General Surgery, Qilu Hospital, Shandong University, Jinan, China.

出版信息

ANZ J Surg. 2021 Jan;91(1-2):106-110. doi: 10.1111/ans.16450. Epub 2020 Nov 17.

Abstract

BACKGROUND

Laparoscopic enucleation of pancreatic tumours is seemingly a simple procedure, but challenging as the tumour is deeply embedded in the pancreatic parenchyma. Our study reports a single-centre experience for these cases.

METHODS

Cases with a tumour underwent laparoscopic enucleation from January 2014 to March 2020 in our hospital were collected and analysed.

RESULTS

Sixty-six cases were enrolled, including 21 men and 45 women with an average age of 43.6 ± 16.7 years old. The mean size of tumours was 2.7 ± 1.8 cm. The tumours were mainly located at the pancreatic head and neck (63.6%). The most common pathological diagnoses were insulinomas, followed by solid pseudopapillary tumours. Incidences of overall complications and pancreatic fistula (PF, Grade B) were 24.2% and 19.7%, respectively. No patient developed PF (Grade C) or died. Cases were divided into two groups according to whether the tumour was deeply embedded in the pancreas. Compared to the group with a superficial tumour (n = 36), the group with an embedded tumour (n = 30) had a longer operation time and drainage duration and a smaller tumour size (P < 0.05), but did not increase the incidence of complications and PF (Grade B/C).

CONCLUSION

Laparoscopic enucleation of tumours that were deeply embedded in the pancreas was technically feasible and safe.

摘要

背景

腹腔镜胰腺肿瘤剜除术看似操作简单,但由于肿瘤深深嵌入胰腺实质,手术颇具挑战性。本研究报告了单中心的相关经验。

方法

收集 2014 年 1 月至 2020 年 3 月期间在我院接受腹腔镜肿瘤剜除术的病例,并进行分析。

结果

共纳入 66 例患者,其中男性 21 例,女性 45 例,平均年龄为 43.6±16.7 岁。肿瘤平均大小为 2.7±1.8cm。肿瘤主要位于胰头颈部(63.6%)。最常见的病理诊断为胰岛素瘤,其次是实性假乳头状瘤。总体并发症和胰腺瘘(PF,B 级)发生率分别为 24.2%和 19.7%。无患者发生 PF(C 级)或死亡。根据肿瘤是否深嵌入胰腺将病例分为两组。与肿瘤表浅组(n=36)相比,肿瘤嵌入组(n=30)的手术时间和引流时间更长,肿瘤体积更小(P<0.05),但并发症和 PF(B/C 级)发生率无增加。

结论

对于深嵌入胰腺的肿瘤,行腹腔镜剜除术在技术上是可行且安全的。

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