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单切口加单孔腹腔镜手术与传统五孔腹腔镜手术用于保留十二指肠的胰头切除术的疗效及安全性比较

The efficacy and safety of single-incision plus one-port laparoscopic surgery conventional five-port laparoscopic surgery for duodenum-preserving pancreatic head resection.

作者信息

Zuo Bangyou, You Xinyu, Jiang Jipeng, Cheng Donghui, Li Peng, Yang Chong, Zhang Yu

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Gland Surg. 2024 Aug 31;13(8):1448-1458. doi: 10.21037/gs-24-200. Epub 2024 Aug 28.

Abstract

BACKGROUND

Single-incision plus one-port laparoscopic duodenum-preserving pancreatic head resection (SILDPPHR+1) is yet to be reported, and therefore, its safety and efficacy have yet to be established. This study aimed to assess the short-term efficacy of SILDPPHR+1 in comparison to conventional laparoscopic duodenum-preserving pancreatic head resection (cLDPPHR).

METHODS

Consecutive patients who underwent SILDPPHR+1 and cLDPPHR procedures were screened. An analysis of the intraoperative and postoperative data of all patients was carried out.

RESULTS

Nineteen patients who underwent SILDPPHR+1 and 24 patients who underwent cLDPPHR at Sichuan Provincial People's Hospital from October 15, 2021, to October 30, 2023, were enrolled in this study. All baseline parameters of both groups were comparable. There was a statistically significant difference in the cosmetic score between the groups (P<0.001). No statistically significant differences were observed between the two groups regarding postoperative recovery, postoperative pancreatic fistula (POPF), bile leakage rate, delayed gastric emptying (DGE) rate, postpancreatectomy hemorrhage (PPH) rate, abdominal infection rate, or textbook outcomes.

CONCLUSIONS

SILDPPHR+1 appears to be a reliable and safe procedure for certain patients, with no increase in the operating time or complications, similar to the results of cLDPPHR. Moreover, SILDPPHR+1 offers the added advantage of superior cosmetic results.

摘要

背景

单切口加单孔腹腔镜保留十二指肠胰头切除术(SILDPPHR+1)尚未见报道,因此,其安全性和有效性尚未确立。本研究旨在评估SILDPPHR+1与传统腹腔镜保留十二指肠胰头切除术(cLDPPHR)相比的短期疗效。

方法

筛选接受SILDPPHR+1和cLDPPHR手术的连续患者。对所有患者的术中及术后数据进行分析。

结果

2021年10月15日至2023年10月30日在四川省人民医院接受SILDPPHR+1手术的19例患者和接受cLDPPHR手术的24例患者纳入本研究。两组的所有基线参数具有可比性。两组之间的美容评分存在统计学显著差异(P<0.001)。两组在术后恢复、术后胰瘘(POPF)、胆漏率、胃排空延迟(DGE)率、胰十二指肠切除术后出血(PPH)率、腹腔感染率或教科书式结局方面未观察到统计学显著差异。

结论

对于某些患者,SILDPPHR+1似乎是一种可靠且安全的手术,手术时间和并发症没有增加,与cLDPPHR的结果相似。此外,SILDPPHR+1还具有美容效果更佳的额外优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e6/11399006/def0cab2e70f/gs-13-08-1448-f1.jpg

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