摘要
目的比较腹腔镜胰十二指肠切除术（LPD）与开腹胰十二指肠切除术（OPD）的临床疗效。方法回顾2014年5月至2016年4月我院肝胆外科85例LPD和60例OPD患者临床资料，比较两组围手术期及预后情况。结果两组患者均顺利完成胰十二指肠切除术。术中出血量分别为（798．2±563．8）ml和（835±486．6）ml，淋巴结清扫数目分别为（6．2±4．8）枚和（7．3±3．9）枚，两组均有1例切缘阳性，差异均无统计学意义（均P〉0．05）。LPD组与OPD组患者手术时间分别为（458．6±81．3）min和（311．9±66．3）min，术后胃管拔除时间分别为（6．1±2．6）d和（7．6±2．5）d，ICU入住时间分别为（2．1±4．1）d和（3．9±5．7）d，下床活动时间分别为（4．3±2．7）d和（7．1±4．0）d，住院时间分别为（18．4±8．3）d和（21．6±10．9）d，差异均有统计学意义（均P〈0．05）。LPD组患者有38例（44．7％）发生术后并发症，OPD组有27例（46．7％）发生术后并发症，两组患者术后并发症发生率差异无统计学意义（P〉0．05）。患者均获得随访，随访期1～30个月，中位随访时间为24个月。LPD组患者生存率为88．2％（75／85），OPD组生存率为85．0％（51／60），两组差异无统计学意义（P〉0．05）。结论LPD在手术出血量、根治效果、并发症发生率、预后等方面能够取得与OPD相同的效果，值得临床推广。
Objective To compare the results between laparoscopic pancreaticoduodenectomy （LPD） and open pancreaticoduodenectomy （OPD） in the treatment of periampullary neoplasms. Methods From May 2014 to April 2016, 145 patients （ 85 patients in the LPD group and 60 patients in the OPD group） underwent pancreaticoduodenectomy in our Department. Their clinical data were analyzed retrospectively. Results All these patients underwent pancreaticoduodenectomy successfully. Volume of intraoperatire blood loss, number of lymph nodes dissected and the number of patients with a positive resection margin were （798.2 ± 563.8） ml, 6.2 ± 4.8 and 1, respectively, in the LPD group, and （835 ±486.6） ml, 7.3 ± 3.9 and 1, respectively, in the OPD group. There were no significant differences between the 2 groups （ all P 〉 0.05 ）. The operation time, the time taken for gastric tube removal, duration of stay in ICU, time to start in normal activity, and duration of hospital stay were （458.6 ± 81.3 ） minutes, （6.1 ± 2.6 ） days, （2.1 ± 4.1 ） days, （4.3 ± 2.7） days and （ 18.4 ± 8.3 ） days, respectively, in the LPD group ; and （311. 9±66.3） minutes, （7.6±2.5） days, （3.9±5.7） days, （7.1 ±4.0） days and （21.6±10.9） days, respectively, in the OPD group. There were significant differences between the 2 groups （ all P 〈 0.05 ）. The complication rate was 44. 7% （38/85） in the LPD group and 46. 7% （28/60） in the OPD group. There were no significant differences in the postoperative complication rates between the 2 groups （P 〉 0.05 ）. All patients were followed up for 1 - 30 months with the median time of 24 months. The survival rate was 88.2% （75/85） in the LPD group and 85.0% （51/60） in the OPD group. There was no significant difference between the 2 groups （P 〉 0.05）. Conclusions Compared with OPD, LPD achieved comparable results in amount of intraoperative blood loss, complication rate and long-term survival. LPD is recommended in clinical pr
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2017年第2期110-113,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胰十二指肠切除术
壶腹周围癌
腹腔镜
并发症
Pancreaticoduodenectomy
Periampullary carcinoma
Laparoscopy
Complications
