微创手术在胰腺神经内分泌肿瘤治疗中的应用（附21例报告）

目的：探讨微创外科手术方式在治疗胰腺神经内分泌肿瘤中的可行性和安全性，了解其的适应证及可能优势。方法：回顾分析我院外科2006年8月至2013年9月微创手术治疗胰腺神经内分泌肿瘤2l例资料，根据手术入路分为机器人手术组（n=13）和腹腔镜手术组（n：8），收集两组病人的围手术期资料。结果：机器人手术组包括胰岛素瘤8例，无功能性神经内分泌肿瘤5例：手术方式为胰十二指肠切除术4例，胰体尾切除术4例，胰腺中段切除2例，Beger手术1例，胰腺肿瘤局部剜除2例。腹腔镜手术组包括胰岛素瘤6例，无功能性神经内分泌肿瘤2例：手术方式为胰十二指肠切除术1例，胰体尾切除术7例。所有病人均顺利完成手术．无中转开腹．无围手术期死亡。随访至今，均无复发及其他并发症发生。结论：微创手术治疗胰腺神经内分泌肿瘤是安全、可行的，术后创伤小、恢复快。机器人手术在治疗胰腺神经内分泌肿瘤的方式上有更多的选择。

Minimally invasive surgery in the treatment of pancreatic neuroendocrine tumor： 21 cases report

Objective The aim of this study was to evaluate the feasibility, safety, indications and possible advantages of minimally invasive surgery in treatment of pancreatic neuroendocrine tumors （PNET）. Methods From Aug 2006 to Sep 2013, 21 patients with pancreatic neuroendocrine tumors underwent minimally invasive pancreatectomies in our department. There were robotic group（n=13） and laparoscopic group（n=8）. Perioperative data were collected and analyzed. Results Eight patients with insulinoma and 5 patients with nonfunctioning PNET were in robotic group in which there were 4 pancreaticoduodenectomies,4 distal pancreatectomies,2 central pancreatectomies, 1 Beger＇s procedure and 2 enucleation. Six patients with insulinoma and 2 patients with PNET were in laparoscopic group, in which there were 1 pancreaticoduodenectomy and 7 distal pancreatectomies. All operations were successfully performed without conversion to open and no mortality. There were no recurrence and without long-term complications during follow-up period. Conclusions Minimally invasive surgery is safe and feasible in the treatment of PNET with less trauma and fast recovery. Robotic surgery is alternative procedure to treat PNET.