摘要
目的探讨比较同期的腹腔镜与开腹胰十二指肠切除术临床效果.方法回顾性分析2016年3月至2018年2月西安交通大学医学部附属咸阳市中心医院收治的62例行胰十二指肠切除术患者的临床资料,根据手术入路分为腹腔镜组(LPD组,30例)和开腹组(OPD组,32例).观察比较两组围手术期情况,采用门诊和电话方式随访其肿瘤转归及生存状态,随访时间截止2018年12月.计数资料和率的比较采用X2检验;正态分布的计量资料以x±s表示,采用t检验.以P<0.05为差异有统计学意义.结果两组患者无围手术期死亡,均成功完成预定Whipple手术,全部采用Child消化道重建吻合.比较两组患者手术完成时间(t=5.382,P<0.05)差异有统计学意义,开腹组短于腹腔镜组.术中出血量、术后应用镇痛药例数、术后肛门排气时间、首次进食时间及术后住院时间等比较(t=3.362,-6.332,-3.526,-1.526,P<0.05),差异有统计学意义,腹腔镜组优于开腹组.术中快速冰冻切片病理学检查切缘阴性及术中输血例次比较(X2=0.001,0.422,P>0.05)两组差异无统计学意义.术后病理学诊断和术后肿瘤学结果比较,差异无统计学意义(P>0.05).两组住院总费用比较(t=0.655,P>0.05),差异无统计学意义.结论LPD是安全可行的,较之OPD手术创伤小,术中出血少,术后恢复速度明显快于开腹手术.随着微创外科与精准外科理念的不断深入,提倡对术前拟诊或已经明确诊断的胰头颈部癌或壶腹周围癌采用腹腔镜探查并行胰十二指肠切除术.
Objective To compare the clinical effects of laparoscopic pancreaticoduodenectomy with simultaneous open pancreaticoduodenectomy.Methods The clinical data of 62 patients with pancreaticoduodenectomy admitted to the Center Hospital of Xianyang City,Xi’an Jiaotong University Health Science from January 2016 to February 2018 were retrospectively analyzed.according to the surgical approach,they were divided into laparoscopic group(LPD group,30 cases)and open group(OPD group,32 cases).The perioperative conditions of the two groups were observed and compared.the prognosis and survival status of the tumors were followed up by outpatient and telephone methods.the follow-up period was until December 2018.X2 test was used to compare the counting data with the rate.The measurement data of normal distribution is expressed as■test is used.The difference was statistically significant with P<0.05.Results No perioperative death occurred in the two groups.all patients successfully completed the scheduled Whipple operation and all underwent Child digestive tract reconstruction and anastomosis.There was statistically significant difference between the two groups(t=5.382,P<0.05)in the completion time of the operation.The open group was shorter than the laparoscopic group.The amount of bleeding during the operation,the number of analgesics used after the operation,the time of anal exhaust after the operation,the time of first eating and the time of hospitalization after the operation were compared(t=3.362,-6.332,-3.526,-1.526,P<0.05)the difference was statistically significant.the laparoscopic group was superior to the open group.There was no statistically significant difference between the two groups(X^2=0.001,0.422,P>0.05)in the pathological examination of intraoperative rapid frozen section and the number of cases of intraoperative blood transfusion.There was no statistically significant difference between the pathological diagnosis after surgery and the results of postoperative oncology(P>0.05).There was no significant differ
作者
张成
安琳
王羊
安东均
杨林
王金涛
韩立
赵宝国
ZHANG Cheng;An Lin;WANG Yang(Department of hepatobiliary surgery,the Center Hospital of xianyang City,Xi’an Jiaotong University Health Science Cente,Xian-yang Shanxi 712000,China;School of Statistics,Xi`an University of Finance and Economics,Xi'an 710100,China)
出处
《肝胆外科杂志》
2020年第2期104-109,共6页
Journal of Hepatobiliary Surgery
关键词
胰头肿瘤
壶腹部周围肿瘤
胰十二指肠切除术
腹腔镜外科
pancreatic head tumor
tumors around the ampulla
pancreaticoduodenectomy
laparoscopic surgery
