以门静脉-肠系膜上静脉为轴心的腹腔镜胰十二指肠切除术16例报道

目的:介绍以门静脉-肠系膜上静脉为轴心的腹腔镜胰十二指肠切除术的方法,探讨其临床价值。方法:回顾分析2015年3月以来完成的16例以门静脉-肠系膜上静脉为轴心的腹腔镜胰十二指肠切除术患者的临床资料。总结腹腔镜胰十二指肠切除术的手术过程,分析此手术方法在临床上的应用效果。结果:16例均行以门静脉-肠系膜上静脉为轴心的腹腔镜胰十二指肠切除术。手术时间350~555 min,平均(470.31±61.09)min;术中出血量100~1 200 ml,平均(568.75±298.26)ml。无围手术期死亡病例。胰瘘发生率为37.5%(6/16),其中A级胰瘘5例,B级1例。结论:以门静脉-肠系膜上静脉为轴心的腹腔镜胰十二指肠切除术是安全、可行、有效的术式。

The technique of laparoscopic pancreaticoduodenectomy surrounding the portal vein-superior mesenteric vein axis:a report of 16 cases

Objective:To describe the method of laparoscopic pancreaticoduodenectomy around the portal vein-superior mesen-teric vein axis,and to evaluate the clinical value of this technique.Methods:The clinical data of 16 patients who underwent laparoscop-ic pancreaticoduodenectomy with this technique since Mar.2015 were retrospectively analyzed.The operative procedures and clinical outcomes were retrospectively reviewed.Results:All patients underwent laparoscopic pancreaticoduodenectomy surrounding the portal vein-superior mesenteric vein axis.The operative time was 350 to 555 min,with an average of (470.31 ±61.09) min and the intraoper-ative blood loss was 100 to 1 200 ml with an average of (568.75 ±298.26) ml.No deaths occurred during the perioperative period.The incidence of postoperative pancreatic fistula was 37.5%(6/16),including 5 grade A cases and 1 grade B case.Conclusions:The lapa-roscopic pancreaticoduodenectomy surrounding the portal vein-superior mesenteric vein axis is a safe,feasible and effective surgical pro-cedure.