摘要
目的:探讨腹腔镜或达芬奇机器人辅助局部切除术治疗胰腺良性及低度恶性肿瘤的围手术期安全性及可行性。方法:回顾分析2020年12月至2021年5月收治的33例行腹腔镜或达芬奇机器人辅助局部切除的胰腺良性肿瘤及低度恶性肿瘤患者的临床资料。肿瘤位于胰头部14例,钩突部5例,胰颈部及体部14例。肿瘤直径平均(3.2±0.8)cm。结果:33例患者中21例行腹腔镜手术,12例行达芬奇机器人手术,手术均获成功,无一例中转开腹,切除肿瘤边界完整。病理结果:导管内乳头状黏液瘤9例,实性假乳头状瘤1例,胰腺神经内分泌肿瘤6例,囊腺瘤17例。术后发生胰瘘29例,其中生化漏16例,B级胰瘘13例,未发生C级胰瘘;腹腔出血1例。无围手术期死亡病例,平均住院(9.8±3.0)d。结论:对于胰腺良性或低度恶性肿瘤,腹腔镜或达芬奇机器人辅助胰腺肿瘤局部切除术创伤小,围手术期安全性高,严重并发症发生率低,可最大限度地保留胰腺功能,减少术后内外分泌功能缺失,值得临床推广。
Objective:To investigate the perioperative safety and feasibility of laparoscopic or Da Vinci robot-assisted local resection for benign and low-grade malignant pancreatic tumor.Methods:The clinical data of 33 patients with benign and low-grade malignant pancreatic tumors who underwent laparoscopic or Da Vinci robot-assisted local resection from Dec.2020 to May 2021 were retrospectively analyzed.The tumor was located in the head of the pancreas in 14 cases,in the uncinate process in 5 cases,and in the neck and body of the pancreas in 14 cases.The average tumor diameter was(3.2±0.8)cm.Results:All 33 patients successfully underwent laparoscopic or Da Vinci robot-assisted local resection of pancreatic tumors,including 21 cases of laparoscopic surgery and 12 cases of Da Vinci robotic surgery.There was no conversion to open surgery and the tumor boundary was intact.The pathological results showed that there were 9 cases of intraductal papillary myxoma,1 case of solid pseudopapillary tumor,6 cases of pancreatic neuroendocrine tumor,and 17 cases of cystadenoma.There were 29 cases of postoperative pancreatic fistula,including biochemical leakage in 16 cases,grade B pancreatic fistula in 13 cases,grade C pancreatic fistula in 0 case,and abdominal hemorrhage in 1 case.There was no perioperative death,and the average hospital stay was(9.8±3.0)d.Conclusions:For patients with benign or low-grade malignant pancreatic tumors,laparoscopic or Da Vinci robot-assisted local tumor resection has few surgical trauma,high perioperative safety,low incidence of serious complications,can furthest preserve pancreatic function and reduce loss of postoperative internal and external secretory function.This procedure can be popularized in clinical practice.
作者
陈升阳
陈艳军
吉顺荣
李晓勇
徐晓武
虞先濬
CHEN Sheng-yang;CHEN Yanjun;JI Shun-rong(Department of Hepatobiliary Pancreatic Surgery,the Fifth Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pancreatic Surgery,Affiliated Cancer Hospital of Fudan University)
出处
《腹腔镜外科杂志》
2023年第2期104-108,共5页
Journal of Laparoscopic Surgery
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200473)。
关键词
胰腺肿瘤
局部切除术
腹腔镜检查
机器人手术
安全
Pancreatic neoplasms
Local excision
Laparoscopy
Robotic surgical procedures
Safety
