腹腔镜胰十二指肠切除术340例报告

目的 探讨腹腔镜胰十二指肠切除术（LPD）可行性。方法 回顾性分析2017 年 3月至 2019年7月山东大学附属省立医院器官移植肝胆外二科开展的340例 LPD 病人临床资料。结果 男性234例,女性106例。平均年龄（59.0±12.4）岁,平均手术时间（230.5±24.6）min,胆肠吻合时间平均（13.5±2.6）min,胰肠吻合时间平均（15.2±3.5）min,胃空肠吻合时间平均（12.2±2.3）min,术中出血量平均（275.4±53.2）mL,术后住院时间平均（11.2±4.5）d。术后发生胰瘘60例（17.65%）,胆瘘32例（9.41%）,胃瘫53例（15.59%）,大出血22例（6.47%）,围手术期死亡5例（1.47%）。结论 对于有丰富开放胰十二指肠切除手术经验及一定腹腔镜手术操作经验的中心,LPD 是一种安全、可行的手术方式。

Laparoscopic pancreaticoduodenectomy:A report of 340 cases

Laparoscopic pancreaticoduodenectomy : A report of 340 cases LIU Jun, XU Shi- feng, YANG Feng-hui, et al. Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021,China
Corresponding author：LIU Jun, LE-mail:dr_liujun1967@126.com
Abstract Objective To evaluate clinical feasibility of laparoscopic pancreaticoduodenectomy (LPD) in perioperative period. Methods The clinical data of 340 consecutive cases who underwent LPD admitted in Department of Hepatobiliary Surgery of Shandong Provincial Hospital Affiliated to Shandong University from March 2017 to July 2019 were analyzed retrospectively. Results The LPDs were successfully completed in the 340 patients. Among them, 234 patients were male and 106 female, aged (59.0±12.4) years on average. The operative time was (230.5±24.6) min, the pancreaticojejunostomy time was (15.2±3.5) min, the bilioenteric anastomosis time was (13.5±2.6) min and the gastrojejunostomy time was (12.2±2.3) min. The intraoperative blood loss was (275.4 ± 53.2) mL. The duration of postoperative hospital stay was (11.2 ± 4.5) days. Postoperative pancreatic fistula occurred in 60 cases (17.65%) and bile fistula in 32 cases (9.41%). Postoperative gastroparesis was found in 53 cases (15.59%). Postoperative hemorrhage in 22 cases (6.47%). Perioperative mortality was in 5 cases (1.47%). Conclusion LPD is safe and feasible for the team with rich experience in open pancreaticoduodenectomy and certain laparoscopic surgery.