摘要
目的探讨腹腔镜胰十二指肠切除术(LPD)学习曲线和临床经验。方法回顾性分析2015年1月至2019年3月在蚌埠医学院第一附属医院行LPD的50例患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男26例,女24例;平均年龄(60±10)岁。根据手术时间将患者分为早期组和后期组,前25例为早期组,后25例为后期组,均由同一组手术医师完成。观察两组围手术期和术后并发症发生情况。两组手术时间等比较采用t检验。BMI和手术时间相关性分析采用直线相关分析。结果早期组4例中转开腹,后期组2例中转开腹,其余均顺利实施LPD。后期组平均手术时间、胰肠吻合时间分别为(406±38)、(42±7)min,明显短于早期组的(457±62)、(53±7)min(t=-3.86,-5.34;P<0.05)。两组术中出血量、术后通气时间、术后住院时间、术后并发症发生率等比较差异无统计学意义(P>0.05)。早期组BMI与手术时间成正相关(r=0.493,P<0.05)。结论LPD手术方式复杂、手术时间较长、术后并发症较多,但通过一定的优化及训练,可逐渐减少手术时间,保证手术安全性,使常规开展LPD成为可能。
Objective To discuss the learning curve and clinical experience of laparoscopic pancreatoduodenectomy(LPD).Methods Clinical data of 50 patients who underwent LPD in the First Affiliated Hospital of Bengbu Medical College from January 2015 to March 2019 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,26 patients were male and 24 female,aged(60±10)years old on average.All the patients were divided into the early stage group(n=25)and late stage group(n=25)according to the date of operation.All operations were completed by the same group of surgeons.Perioperative conditions and postoperative complications were observed between two groups.The operation time was statistically compared between two groups by t test.The correlation between body mass index(BMI)and operation time was conducted by linear correlation analysis.Results In the early stage group,4 patients were converted to open surgery,and 2 cases in the late stage group.The remaining patients underwent LPD successfully.In late stage group,the average operation time and pancreaticojejunostomy time were(406±38)min and(42±7)min respectively,significantly shorter than(457±62)min and(53±7)min in early stage group(t=-3.86,-5.34;P<0.05).However,the intraoperative blood loss,postoperative ventilation time,length of postoperative hospital stay and complications did not significantly differ between two groups(P>0.05).BMI was positively correlated with the operation time in early stage group(r=0.493,P<0.05).Conclusions LPD is a complex procedure with long operation time and more postoperative complications.Nevertheless,certain optimization and training can gradually shorten the operation time and guarantee the safety of operation,making it possible to performing LPD routinely.
作者
何辉虎
张登勇
孙万亮
马翔
鲁正
He Huihu;Zhang Dengyong;Sun Wanliang;Ma Xiang;Lu Zheng(Graduate School,Bengbu Medical College,Bengbu 233000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中华肝脏外科手术学电子杂志》
CAS
2020年第2期176-180,共5页
Chinese Journal of Hepatic Surgery(Electronic Edition)
关键词
腹腔镜
胰十二指肠切除术
治疗
手术后并发症
Laparoscopes
Pancreaticoduodenectomy
Treatment
Postoperative complications
