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腹腔镜切除 12 只犬胰腺肿块。

Laparoscopic resection of pancreatic masses in 12 dogs.

机构信息

Clinica Veterinaria Apuana AniCura, Carrara, Italy.

Escuela de Medicina Veterinaria, Facultad Ciencias de la Vida, Universidad Andres Bello, Vina del Mar, Chile.

出版信息

Vet Surg. 2024 Jul;53(5):860-871. doi: 10.1111/vsu.14057. Epub 2023 Dec 13.

Abstract

OBJECTIVE

To describe the surgical management and outcome of dogs undergoing laparoscopic pancreatic mass resection (LPMR).

STUDY DESIGN

Retrospective study.

ANIMALS

Twelve client-owned dogs.

METHODS

Data collected from medical records of dogs that underwent LPMR between 2012 and 2023 included signalment, clinical signs, mass location within pancreas, preoperative diagnostic imaging, laparoscopic approach, number of portals and device type used for LPMR, operating time, complications and clinical outcome.

RESULTS

Pancreatic tumors were located in the left lobe (7), in the right lobe (4) and in the body of the pancreas (1). A 3- or 4-port technique was used in nine and three dogs, respectively. LPMR was performed with the Ligasure in nine dogs, a harmonic scalpel in two dogs and an endoscopic stapler in one dog. The procedure was performed successfully, with no conversion to open laparotomy, in all cases with a median operating time of 69 min. Postoperative complications occurred in four dogs, which resolved with medical treatments. All dogs survived the surgical procedure, were discharged from the hospital and alive a minimum of 90 days postoperatively. The final follow-up time ranged between 105 and 245 days (median 147). Histopathological diagnosis included insulinoma (9) and pancreatic carcinoma (3).

CONCLUSION

LPMR was performed successfully using a 3- or 4-port technique and was associated with a low complication rate and a good clinical outcome.

CLINICAL SIGNIFICANCE

LPMR may be considered as an alternative to open celiotomy in dogs, particularly for small tumors located in the distal aspect of the pancreatic lobes.

摘要

目的

描述接受腹腔镜胰腺肿块切除术(LPMR)的犬的手术管理和结果。

研究设计

回顾性研究。

动物

12 只患犬。

方法

收集 2012 年至 2023 年期间接受 LPMR 的犬的病历数据,包括一般信息、临床症状、胰腺内肿块位置、术前诊断影像学检查、腹腔镜方法、LPMR 使用的端口数量和设备类型、手术时间、并发症和临床结果。

结果

胰腺肿瘤位于左叶(7 个)、右叶(4 个)和胰腺体(1 个)。9 只犬使用 3 或 4 端口技术,3 只犬使用 3 或 4 端口技术。LPMR 分别使用 Ligasure 在 9 只犬、超声刀在 2 只犬和内镜吻合器在 1 只犬中进行。所有病例均成功完成手术,无中转开腹,中位手术时间为 69 分钟。4 只犬术后发生并发症,经药物治疗后痊愈。所有犬均存活并顺利出院,术后至少 90 天存活。最终随访时间为 105 至 245 天(中位数 147 天)。组织病理学诊断包括胰岛素瘤(9 个)和胰腺腺癌(3 个)。

结论

使用 3 或 4 端口技术成功进行 LPMR,并发症发生率低,临床结果良好。

临床意义

LPMR 可作为犬开腹手术的替代方法,特别是对于位于胰腺叶远端的小肿瘤。

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