腹腔镜胰十二指肠切除术的疗效分析

目的评估腹腔镜胰十二指肠切除术的疗效,探讨腹腔镜胰十二指肠切除术的安全性和可行性。方法回顾性分析2014年1月~2016年12月我院43例胰十二指肠切除术患者的临床资料,其中腹腔镜22例,开腹21例。对比二组患者手术时间、术中出血量、术后肛门排气时间、术后住院时间、术后并发症和清扫淋巴结数目。结果与开腹组比较,腹腔镜组总的手术时间长(414.0±31.0 min vs.263.8±34.4 min,t=11.634,P0.001),但术中出血量少(176.0±50.4 m L vs.290.8±41.9 m L,t=-6.613,P=0.01),术后肛门排气早(4.9±0.7 d vs.6.7±0.8 d,t=-5.724,P=0.025),术后住院时间短(17.3±2.0 d vs.21.3±3.2 d,t=-3.514,P=0.002),二组术后并发症、清扫淋巴结数目的差异无统计学意义。结论与开腹手术相比,腹腔镜胰十二指肠切除术同样遵循肿瘤根治原则,而且安全可行。

An analysis between laparoscopic and open pancreaticoduodenectomy

Objective To evaluate the curative effects of laparoscopic pancreaticoduodenectomy（LPD），and discuss the safety and feasibility of LPD. Methods Retrospective analysis was conducted in clinical data of pancreaticoduodenectomy from January 2012 to December 2016，including 22 cases of laparoscopic pancreaticoduodenectomy and 21 cases of open pancreaticoduodenectomy（OPD）. The related outcomes of the two groups were compared ，which included operation time ，intraoperative blood loss ， intraoperative blood transfusion rate，postoperative anal exhaust time，postoperative hospital stay and postoperative complication. Results The laparoscopic group had significantly longer operation time（414.0±31.0 min vs. 263.8±34.4 min，t=11.634，P<0.001），however，shorter intraoperative blood loss（176.0±50.4 mL vs. 290.8±41.9 mL，t= -6.613，P=0.01），postoperative anal exhaust time（4.9±0.7 d vs. 6.7±0.8 d，t=-5.724，P=0.025）and postoperative hospital stay（17.3±2.0 d vs. 21.3±3.2 d，t=-3.514，P=0.002）than those in the open group（all P values were less than 0.05）. Conclusion Compared with OPD，LPD follows the principle of tumor occurring，which is safe and feasible.