完全腹腔镜下与开腹胰十二指肠切除术治疗壶腹周围肿瘤近期疗效比较

目的探讨完全腹腔镜下胰十二指肠切除术(TLPD)与开腹胰十二指肠切除术(OPD)治疗壶腹周围肿瘤的近期疗效。方法回顾性分析山西医科大学第一医院2016年6月至2019年3月收治的50例壶腹周围肿瘤患者的临床资料,根据手术方式不同分为TLPD组(22例)及OPD组(28例),比较两组患者围术期及术后各项指标情况。结果两组患者均顺利完成手术,TLPD组手术时间[(665±213)min]长于OPD组[(447±215)min],差异有统计学意义(t=-0.356,P=0.001);TLPD组术中出血量[100 ml(50~325 ml)]少于OPD组[300 ml(100~500 ml)],差异有统计学意义(Z=-2.230,P=0.026)。TLPD组与OPD组术中输血者比例、淋巴结清扫数量、切除肿瘤长径、术后禁饮食时间、术后拔管时间、术后住院时间及术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论TLPD与OPD治疗壶腹周围肿瘤临床近期疗效相近,TLPD手术时间较OPD长,但可有效控制术中出血量。

Short-term efficacy comparison of totally laparoscopy and open pancreatoduodenectomy in the treatment of periampullary carcinoma

Objective To explore the short-term efficacy of totally laparoscopy pancreatoduodenectomy(TLPD)and open pancreatoduodenectomy(OPD)in the treatment of periampullary carcinoma.Methods The clinical data of 50 patients with periampullary carcinoma in the First Hospital of Shanxi Medical University from June 2016 to March 2019 were retrospectively analyzed.According to the different surgical methods,the patients were divided into TLPD group(22 cases)and OPD group(28 cases).The perioperative and postoperative related indicators between the two groups were compared.Results Both groups had successfully received the operation.The operating time in TLPD group was longer than that in OPD group,and the difference between the two groups was statistically significant[(665±213)min vs.(447±215)min,t=-0.356,P=0.001].The amount of intraoperative bleeding in TLPD group was less than that in OPD group,and the difference between the two groups was statistically significant[100 ml(50-325 ml)vs.300 ml(100-500 ml),Z=-2.230,P=0.026].There were no significant differences in the proportion of intraoperative blood transfusion,lymph node dissection number,resected tumor diameter,postoperative diet restriction time,postoperative extubation time,postoperative hospital stay and the incidence of postoperative complication between TLPD group and OPD group(all P>0.05).Conclusions TLPD and OPD has a similar short-term efficacy in the treatment of periampullary carcinoma.The operating time of TLPD is longer than that of OPD,but TLPD can effectively control the intraoperative bleeding.