腹腔镜保留十二指肠全胰头切除术治疗胰头实性假乳头状肿瘤的临床体会(附4例报告)

目的:探讨腹腔镜保留十二指肠全胰头切除术治疗胰头实性假乳头状肿瘤的安全性及可行性。方法:回顾分析2019年4月至2019年10月为4例胰头部实性假乳头状肿瘤患者行腹腔镜保留十二指肠全胰头切除术的围手术期资料。结果:4例患者中女3例,男1例,中位年龄22岁。4例患者均成功完成腹腔镜保留十二指肠全胰头切除术,无中转开腹。中位手术时间215 min,中位出血量200 mL。4例患者均达到R0切除。术后1例出现胆漏,予以保守治疗好转;1例发生生化漏,未发生B/C级胰瘘、腹腔出血、胃排空障碍、十二指肠缺血坏死等并发症。术后中位住院时间14 d,围手术期无死亡病例。结论:腹腔镜保留十二指肠全胰头切除术治疗胰头实性假乳头状肿瘤是安全、可行的,但其长期疗效及患者远期生活质量需要进一步研究。

Laparoscopic duodenum-preserving pancreatic head resection for solid pseudopapillary tumor located at the pancreatic head:with a report of 4 cases

Objective:To investigate the safety and feasibility of laparoscopic duodenum-preserving pancreatic head resection(LDPPHR)for solid pseudopapillary tumor located at the pancreatic head.Methods:From Apr.2019 to Oct.2019,the perioperative data of 4 patients with solid pseudopapillary tumor located at the pancreatic head who underwent LDPPHR were analyzed retrospectively.Results:Three female patients and one male patient were included in this study.The median age was 22 years.All LDPPHRs were successful and R0 resection in the 4 patients without conversion to laparotomy.The median operation time was 215 min and the median estimated blood loss was 200 mL.Two patients suffered from surgery-related complications.One patient suffered from bile leakage,which was cured by conservative treatment.One patient suffered from biochemical fistula.No patient suffered from grade B/C pancreatic fistula,abdominal hemorrhage,delayed gastric emptying,or duodenal ischemia.The median postoperative hospital stay was 14 d.There was no peri-operative mortality in this study.Conclusions:LDPPHR is safe and feasible in treatment of solid pseudopapillary tumor of the pancreatic head,however,its long-term effect and long-term quality of life of patients require further study.