腹腔镜胰十二指肠切除术12例报告

目的：探讨腹腔镜胰十二指肠切除术的价值。方法：回顾分析2005年5月至2008年7月为12例患者施行腹腔镜胰十二指肠切除术的临床资料。结果：5例完全腹腔镜下操作,4例行手助腹腔镜手术,3例中转开腹。手术时间5~10h,平均6.5h。术中出血200~800ml,平均435ml。术后第1天腹腔引流量30~120ml,平均65ml,术后1~4d排气,平均2d。1例术后第6天出现胆漏,引流量最多40ml/d,术后14d拔除引流管。住院11~21d,平均15d。术后随访3~36个月,2例胰头癌患者分别存活16个月和22个月,1例胆总管下段癌患者术后15个月发现肝脏和腹膜后淋巴结转移,其余9例无并发症发生。结论：腹腔镜胰十二指肠切除术具有一定的微创优势,安全可行。

Report of 12 cases laparoscopic pancreaticoduodenectomy

Objective:To discuss the value of laparoscopic pancreaticoduodenectomy.Methods:The clinical data of 12 patients who underwent laparoscopic pancreaticoduodenectomy from May 2005 to Jul.2008 were retrospectively analyzed.Results:Five cases were treated by totally laparoscopic surgery,4 cases by hand-assisted laparoscopic surgery and 3 cases were converted to open surgery.All of the operations were completed successfully with an average operating time of 6.5h(range 5-10h) and mean intraoperative blood loss of 435ml(range 200-800ml).The median amount of postoperative abdominal drainage of the first-day was 65ml(range 30-120ml) and the average aerofluxus time was 2 days(range 1-4 days).1 case occurred bile leakage and the maximum drainage was 40ml/d.The drainage tubes were removed on the 14th day after operation.The median postoperative hospital stay was 15 days(range 11-21 days).During a follow-up of 6 months to 3 years,2 patients of pancreas head carcinoma survived 16 and 22 months respectively,1 patient with lower part of common bile duct cancer was detected liver and retroperitoneal lymph node metastasis in 15th month after operation,and no complications were found in other 9 patients.Conclusions:The laparoscopic pancreaticoduodenectomy is a safe,feasible and mini-invasive operation.