摘要
目的:比较腹腔镜胰十二指肠切除术合并扩大淋巴结清扫与开腹手术的临床疗效。方法 :回顾性分析我院2014年7月至2016年7月185例胰十二指肠切除术病人中160例病人的临床资料。按手术方式分为腔镜组和开腹组,其中腔镜组84例,开腹组76例。比较两组病人在术后胰漏、胆漏、出血、胃排空障碍的发生率以及淋巴结清扫数、手术时间和住院时间。结果:腔镜组与开腹组相比,年龄、性别、主要合并症等差异无统计学意义(P>0.05)。术后胆漏、胃排空障碍、出血、腹泻发生率以及手术时间、住院时间和下床时间均无统计学差异。腔镜组淋巴结清扫数较多,胰漏尤其是B级和C级胰漏发生率以及总并发症发生率明显下降(P<0.05)。结论:腹腔镜胰十二指肠切除术中扩大淋巴结清扫,可清除更多淋巴结,并降低胰漏发生率和术后总并发症发生率,有利于肿瘤病理分期,有利于延缓肿瘤复发。
Objective To compare the clinical effect between laparoscopic pancreaticoduodenectomy （LPD） with ex- tended lymphadenectomy and open pancreaticoduodenectomy （OPD） with extended lymphadenectomy. Methods Out of a total of 185 cases of pancreatoduodenectomy in our hospital from July 2014 to July 2016, 160 cases were selected to re- view their clinical data in this retrospective analysis. Eighty-four cases were in laparoscopic group and 76 cases in open group. Postoperative pancreatic fistula, biliary fistula, bleeding, gastroparesis, the number of lymph node dissection, opera- tion time and hospital stay were compared between two groups. Results There was no significant difference of age, gender and major complications between two groups （P〉0.05）. No significant differences were observed in operation time, hospital stay and bed time. Laparoscopie group was associated with more lymph node dissection, lower incidence of pancreatic fis- tula, especially B grade and C grade （P〈0.05）. Total postoperative mobility incidence decreased in laparoscopic group compared with that in open group （P〈0.05）, although biliary fistula, gastroparesis, bleeding and diarrhea was similar for both the groups. Conclusions LPD combined with extended lymphadenectomy has advantage for more lymph node dissect- ed, pancreatic fistula and total mobility reduced over OPD with extended lymphadeneetomy. This technique can help for pathological staging of tumor and reducing the recurrence.
出处
《外科理论与实践》
2017年第2期117-122,共6页
Journal of Surgery Concepts & Practice
基金
国家自然科学基金(81602475
81502633
81402443)
国家"十一五"支撑项目(2006BAI02A13-402)
关键词
腹腔镜
胰十二指肠切除术
胰头癌
淋巴结清扫
胰漏
Laparoscopy
Pancreaticoduodenectomy
Pancreas head cancer
Lymph node dissection
Pancreaticfistula
