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机器人胰十二指肠切除术的围手术期结果:一位外科医生连续55例病例的经验

Perioperative outcomes of robotic pancreaticoduodenectomy: a single surgeon's experience with 55 consecutive cases.

作者信息

Lin Ronggui, Lin Xianchao, Pan Maoen, Lu Fengchun, Yang Yuanyuan, Wang Congfei, Fang Haizong, Chen Yanchang, Huang Heguang

机构信息

Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.

出版信息

Gland Surg. 2021 Jan;10(1):122-129. doi: 10.21037/gs-20-552.

Abstract

BACKGROUND

Robotic pancreaticoduodenectomy (RPD) has been increasingly performed for patients with periampullary tumours and tumours in the pancreatic head. This method offers several technical advantages compared to open and laparoscopic surgeries. However, the surgical results often vary depending on the experience of different pancreatic centres.

METHODS

A retrospective study of our first 55 cases of RPD from August 2016 to April 2020 was conducted to evaluate the perioperative outcomes of RPD and to summarize the operative experiences in a single intuition. Benign and malignant tumours in the pancreatic head or periampullary tumours without obvious vascular and adjacent organ invasion were included in this study. Perioperative characteristics and postoperative complications of the enrolled patients were retrospectively collected.

RESULTS

The first 17 cases were robot-assisted laparoscopic pancreaticoduodenectomy (RA-LPD) and the remaining 38 patients underwent total RPD. The RA-LPD group had a remarkably longer operative time than the total RPD group (415.3±89.2 362.4±75.6 min, P=0.047). The incidences of biliary leakage, chyle leakage, DGE, intra-abdominal infection and intra-abdominal haemorrhage were 3.6%, 0.0%, 5.5%, 9.1% and 5.5%, respectively. Two patients underwent relaparotomy due to severe intra-abdominal haemorrhage. The median length of hospital stay was 14 (11 to 19) days. There were no deaths during the perioperative period.

CONCLUSIONS

RPD is a technically feasible procedure for selected patients with periampullary tumours and tumours in the pancreatic head in experienced hands.

摘要

背景

机器人胰十二指肠切除术(RPD)已越来越多地应用于壶腹周围肿瘤和胰头肿瘤患者。与开放手术和腹腔镜手术相比,这种方法具有若干技术优势。然而,手术结果往往因不同胰腺中心的经验而异。

方法

对2016年8月至2020年4月期间我们进行的首例55例RPD病例进行回顾性研究,以评估RPD的围手术期结果,并在单一机构总结手术经验。本研究纳入胰头良性和恶性肿瘤或无明显血管及相邻器官侵犯的壶腹周围肿瘤。回顾性收集入组患者的围手术期特征和术后并发症。

结果

前17例为机器人辅助腹腔镜胰十二指肠切除术(RA-LPD),其余38例患者接受了全RPD。RA-LPD组的手术时间明显长于全RPD组(415.3±89.2对362.4±75.6分钟,P = 0.047)。胆漏、乳糜漏、胃排空延迟、腹腔内感染和腹腔内出血的发生率分别为3.6%、0.0%、5.5%、9.1%和5.5%。2例患者因严重腹腔内出血接受了再次剖腹手术。中位住院时间为14(11至19)天。围手术期无死亡病例。

结论

对于经验丰富的医生而言,RPD对于选定的壶腹周围肿瘤和胰头肿瘤患者是一种技术上可行的手术。

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