胰管修复外科在胰腺囊腺瘤手术的临床应用

目的探讨胰管修复外科的术式在治疗胰腺囊腺瘤的临床疗效。 方法回顾性分析2016年9月至2021年9月期间解放军总医院第一医学中心采用胰管修复外科术式治疗的胰腺囊腺瘤52例患者临床资料。 结果21例为局部切除＋主胰管修复术，其手术时间、术中出血量、肿瘤最大直径、术后住院时间中位数分别为135 min、20 ml、2.6 cm、9.0 d，B级胰瘘率33.3%；31例胰腺端端吻合术，其手术时间、术中出血量、肿瘤最大直径、术后住院时间中位数分别为132 min、50 ml、2.5 cm、6.0 d，B级胰瘘率41.9%；术后严重并发症1例，术后出血1例，两种术式均无二次手术、死亡病例。 结论胰管修复外科在胰腺囊腺瘤手术的临床应用是安全、可行的，能最大程度地保留胰腺组织结构和其生理功能，避免了胃肠道的损伤与骚扰。

Application of pancreatic duct reconstructive surgery in pancreatic cystadenoma

ObjectiveTo investigate the clinical effect of pancreatic duct reconstructive in the treatment of pancreatic cystadenoma. MethodsThe clinical data of 52 patients with pancreatic cystadenoma underwent pancreatic duct reconstructive surgery in our department from Sep. 2016 to Sep. 2021 were retrospectively analyzed. Results21 patients were treated with enucleation + pancreatic duct reconstructive. The median of operation time, estimated blood loss, tumor size, and postoperative hospital stay were 135 min, 20 ml, 2.6 cm, and 9.0 days, respectively. And the grade B pancreatic fistula rate was 33.3%. 31 patients were treated with end-to-end pancreatic anastomosis. The median of operation time, estimated blood loss, tumor size, and postoperative hospital stay were 132 min, 50 ml, 2.5 cm, 6.0 days, and the grade B pancreatic fistula rate was 41.9%. There was 1 case of serious complication, 1 case of postoperative haemorrhage. There was no second operation and death in both group. ConclusionsPancreatic duct reconstructive surgery for pancreatic cystadenoma is safe and feasible. This procedure can preserve the pancreatic tissue structure and its physiological function, avoiding damage the gastrointestinal tract.