School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Pancreatic Surgery, General Surgery, Qilu Hospital, Shandong University, Jinan, China.
ANZ J Surg. 2021 Jan;91(1-2):106-110. doi: 10.1111/ans.16450. Epub 2020 Nov 17.
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.
Cases with a tumour underwent laparoscopic enucleation from January 2014 to March 2020 in our hospital were collected and analysed.
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).
Laparoscopic enucleation of tumours that were deeply embedded in the pancreas was technically feasible and safe.
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。
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。
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。
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。