手助腹腔镜技术在胰体尾切除术中的应用

目的：探讨手助腹腔镜胰体尾切除术的安全性和有效性。方法：回顾分析2002年9月至2009年12月施行的10例手助腹腔镜胰体尾切除术与14例开腹胰体尾切除术的临床资料。结果：腹腔镜组手术切口（4.8±0.8）cm]显著短于开腹组（14.4±2.6）cm]（P〈0.001）,术中出血量（116.0±64.8）m l]少于开腹组（328.6±314.8）m l]（P=0.048）,术后恢复肛门排气时间（2.8±0.6）d]显著短于开腹组（3.9±0.7）d]（P=0.002）,术后恢复饮食时间（3.7±0.7）d]显著短于开腹组（4.7±0.8）d]（P=0.001）,术后住院时间（9.5±4.2）d]显著短于开腹组（12.7±2.7）d]（P=0.033）。而两组手术时间、术后并发症发生率差异无统计学意义。结论：手助腹腔镜胰体尾切除术患者创伤小,手术时间短,术后康复快,是治疗胰体尾肿瘤安全、可行的方法。

Application of hand-assisted laparoscopic distal pancreatectomy

Objective:The aim of this study was to evaluate the safety and efficacy of hand-assisted laparoscopic distal pancreatectomy(HLDP) and compare it with open distal pancreatectomy(open-DP).Methods:Twenty-four patients who underwent distal pancreatectomy(HLDP,10 patients;open-DP,14 patients) between Sep.2002 and Dec.2009 in department of general surgery of Shanghai Changzheng Hospital were enrolled in this study.Their clinical data were compared.Results:The incision for HLDP group(4.8±0.8)cm] was significantly shorter than that in the open-DP group(14.4±2.6)cm](P<0.001).Blood loss in the HLDP group (116.0±64.8) ml] was significantly less than that in the open-DP group (328.6±314.8)ml](P=0.048).And,none of the patients in the HLDP group received conversions.The average time of first passage of flatus(2.8±0.6)d vs.(3.9±0.7)d;P=0.002],time of oral intake(3.7±0.7)d vs.(4.7±0.8)d;P=0.001] and hospital stay (9.5±4.2)d vs.(12.7±2.7)d;P=0.033)] in the HLDP group were significantly shorter than those in the open-DP group.The operative time and the incidence of postoperative complications in HLDP and open-DP groups were not significantly different.Conclusions:HLDP for distal pancreatic neoplasms is safe and feasible.The procedure appears to be mini-invasive and rapid,and it is accompanied by an accelerated recovery.