3D打印技术在腹腔镜保脾胰体尾切除术中的应用

doi:10.3969/j.issn.1006-5725.2019.16.009

实用医学杂志 ›› 2019, Vol. 35 ›› Issue (16): 2555-2559.doi: 10.3969/j.issn.1006-5725.2019.16.009

3D打印技术在腹腔镜保脾胰体尾切除术中的应用

刘文瑛¹, 杨剑², 朱剑华¹, 谭勇¹, 欧阳再兴¹, 刘欣¹, 朱玉珍¹, 黄从云¹

1汕头大学附属粤北人民医院（广东韶关 512025）;
2南方医科大学珠江医院（广州 510280）

收稿日期:2019-04-14 出版日期:2019-08-27 发布日期:2019-08-27
通讯作者: 黄从云 E-mail： hcy804@qq.com
基金资助:
国家自然科学基金项目（编号：81601576）; 韶关市卫生计生科研项目（编号：Y19020,Y16027）; 韶关市科技计划项目（编号：2016CX006）

Clinical application of three-dimensional printing technology in laparoscopic splenic-preserving distal pancreatectomy

LIU Wenying^*, YANG Jian, ZHU Jianhua, TAN Yong, OUYANG Zaixing, LIU Xin, ZHU Yuzhen, HUANG Congyun

*Yuebei People′s Hospital of Shantou University, Shaoguan 512025, China

Received:2019-04-14 Online:2019-08-27 Published:2019-08-27
Contact: HUANG Congyun E-mail： hcy804@qq.com

摘要/Abstract

摘要： 目的探讨3D打印技术在腹腔镜保脾胰体尾切除手术中的临床应用价值。方法回顾性分析粤北人民医院2014年10月至2018年12月50例腹腔镜保脾胰体尾切除术患者临床资料,其中3D打印技术指导手术组（3D组）22例,对照组28例。观察分析两组患者的手术方法、手术时间、术中出血量、术后腹腔引流量、术后住院时间、并发症等指标。结果 3D组19例、对照组22例患者成功施行腹腔镜保脾胰体尾切除手术,3D组的手术成功率和Kimura法手术率高于对照组,但差异无统计学意义（P > 0.05）;3D组的手术时间[（126.8 ± 24.1）min vs. （143.8 ± 26.9）min]、术中出血量[（107.3 ± 27.7）mL vs. （131.5 ± 31.8）]mL、术后腹腔引流量第1天[（28.4 ± 12.3）mL vs. （37.0 ± 13.9）mL]、第2天[（16.8 ± 6.7）mL vs. （21.8 ± 7.5）mL]均低于对照组,差异有统计学意义（P < 0.05）;无手术相关并发症。术后住院时间[（6.8 ± 1.8）d vs. （7.6 ± 2.1）d],3D组低于对照组,差异无统计学意义（P > 0.05）。结论 3D打印技术可提高腹腔镜保脾胰体尾切除术的成功率和安全性,手术更加精准和微创。

关键词: 3D打印, 精准胰腺外科, 腹腔镜

Abstract: Objective To study the practical value of three-dimensional printing technology in laparoscopic splenic-preserving distal pancreatectomy. Methods The clinical data of 50 patients who underwent laparoscopic splenic-preserving distal pancreatectomy in the guiding of three-dimensional printing technology between Oct, 2014 and Dec. 2018 in Yuebei People′s Hospital were retrospectively analyzed. Three-dimensional printing technology was applied in 22 patients （3D group）, the other 28 patients were distributed in the control group. The clinical therapeutic Results including operation method, operation time, intraoperative blood loss, postoperative drainage, postoperative hospitalization and complications were observed and analyzed. Results Laparoscopic splenic-preserving distal pancreatectomy was successfully performed in 19 patients in 3D group and 22 patients in control group. The success rate of operation and Kimura method in 3D group were higher than those in the control group, but there was no statistical difference between these two groups （P > 0.05）. The operation time in 3D group [（126.8 ± 24.1）min vs. （143.8 ± 26.9）min], intraoperative blood loss volume[（107.3 ± 27.7）mL vs. （131.5 ± 31.8）]mL, post-operative drainage volume in first day [（28.4±12.3）mL vs （37.0±13.9）mL] and in second day [（16.8 ± 6.7）mL vs. （21.8 ± 7.5）mL] were less than those of the control group （P < 0.05）. The days of postoperative hospital stay in 3D group [（6.8 ± 1.8）d vs. （7.6 ± 2.1）d] was shorter than that in the control group, despite that there was no significant difference between two groups （P > 0.05）. In addition, both of these two groups didn′t have any operative complication. Conclusion The success rate and the operation security of laparoscopic splenic-preserving distal pancreatectomy were improved under the guiding of three-dimensional printing technology, which contributes to the surgery to become more precise and have minimal invasion.

Key words: three-dimensional printing, precise pancreatectomy, laparoscopy

刘文瑛, 杨剑, 朱剑华, 谭勇, 欧阳再兴, 刘欣, 朱玉珍, 黄从云. 3D打印技术在腹腔镜保脾胰体尾切除术中的应用[J]. 实用医学杂志, 2019, 35(16): 2555-2559.

LIU Wenying, YANG Jian, ZHU Jianhua, TAN Yong, OUYANG Zaixing, LIU Xin, ZHU Yuzhen, HUANG Congyun. Clinical application of three-dimensional printing technology in laparoscopic splenic-preserving distal pancreatectomy[J]. The Journal of Practical Medicine, 2019, 35(16): 2555-2559.

参考文献 21

[1]	DAI M H, SHI N, XING C, et al.Splenic preservation in laparoscopic distal pancreatectomy[J]. Br J Surg,2017,104(4):452-462.
[2]	KIM H S, PARK J S, YOON D S.True learning curve of laparoscopic spleen-preserving distal pancreatectomy with splenic vessel preservation[J]. Surg Endosc,2019,33(1):88-93.
[3]	FINGERHUT A, URANUES S, KHATKOV I, et al.Laparoscopic distal pancreatectomy: Better than open?[J]. Translational gastroenterology and hepatology,2018,3:49.
[4]	刘允怡,张绍祥,姜洪池,等. 肝门部胆管癌三维可视化精准诊治专家共识[J]. 中国实用外科杂志,2017,37(1):48-52.
[5]	刘允怡,张绍祥,姜洪池,等. 复杂性肝脏肿瘤三维可视化精准诊治专家共识[J]. 中国实用外科杂志,2017, 37(1):53-59.
[6]	MATSUMOTO I, KAMEI K, SATOI S, et al.Laparoscopic versus open distal pancreatectomy for benign and low-grade malignant lesions of the pancreas: A single-center comparative study[J]. Surg Today,2019,49(5):394-400.
[7]	BAUMAN M D, BECERRA D G, KILBANEe E M, et al.Laparoscopic distal pancreatectomy for pancreatic cancer is safe and effective[J]. Surgical Endoscopy,2018,32(1):53-61.
[8]	刘宇斌. 应重视肝胆胰腺微创外科治疗的研究[J]. 实用医学杂志,2016,32(12):1899-1901.
[9]	PARK D J, HAN I W, HAN S H, et al.Splenic vessel patency: Is it real menace to perform laparoscopic splenic vessel-preserving distal pancreatectomy[J]. Ann Surg Treat Res,2019,96(3):101-106.
[10]	RUTKOSKI J D, SEGURA B J, KANE T D.Experience with totally laparoscopic distal pancreatectomy with splenic preservation for pediatric trauma--2 techniques[J]. J Pediatr Surg,2011,46(3):588-593.
[11]	SUZUMURA K, HATANO E, OKADA T, et al.Perioperative and long-term outcome of the Warshaw technique in laparoscopic spleen-preserving distal pancreatectomy[J]. Surg Laparosc Endosc Percutan Tech,2017,27(6):474-478.
[12]	KIM H, SONG K B, HWANG D W, et al.A single-center experience with the laparoscopic Warshaw technique in 122 consecutive patients[J]. Surgical Endoscopy,2016,30(9):4057-4064.
[13]	LEE L S, HWANG H K, KANG C M, et al.Minimally invasive approach for spleen-preserving distal pancreatectomy: A comparative analysis of postoperative complication between splenic vessel conserving and Warshaw′s technique[J]. Journal of Gastrointestinal Surgery,2016,20(8):1464-1470.
[14]	杨鸿国,胡智明,吕佳,等. 动脉优先处理行保留脾脏腹腔镜胰体尾切除术15例[J]. 浙江临床医学,2017,19(4):728-730.
[15]	段小辉,毛先海,周力学,等. 3D腹腔镜在保脾胰体尾切除术中的应用价值[J]. 中华肝脏外科手术学电子杂志,2017, 6(1):24-28.
[16]	CHEN S, ZHAN Q, CHEN J, et al.Robotic approach improves spleen-preserving rate and shortens postoperative hospital stay of laparoscopic distal pancreatectomy: A matched cohort study[J]. Surg Endosc,2015,29(12):3507-3518.
[17]	刘盖,李晓锋,曾宪成,等. 三维重建技术在胰腺浆液性囊腺瘤手术规划中的应用研究[J]. 消化肿瘤杂志(电子版),2017, 9(2):116-118.
[18]	黄从云,朱剑华,刘欣,等. 3D打印技术在肝脏切除术中的应用[J]. 中国普外基础与临床杂志,2015, 22(11):1351-1353.
[19]	PANDA N, BANSAL N K, NARSIMHAN M, et al.Spleen-preserving versus spleen-sacrificing distal pancreatectomy in laparoscopy and open method-perioperative outcome analysis-14 years experience[J]. Indian J Surg,2016,78(2):90-95.
[20]	WANG K, FAN Y.Minimally invasive distal pancreatectomy: review of the English literature[J]. J Laparoendosc Adv Surg Tech,2017,27(2):134-140.
[21]	KIMURA W, YANO M, SUGAWARA S, et al.Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein: Techniques and its significance[J]. J Hepatobiliary Pancreat Sci,2010,17(6):813-823.

3D打印技术在腹腔镜保脾胰体尾切除术中的应用

Clinical application of three-dimensional printing technology in laparoscopic splenic-preserving distal pancreatectomy

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 21

相关文章 3

编辑推荐

Metrics

本文评价

[1]	胡欢欢, 钟志惟, 宁克, 王超, 袁春晖, 殷香保. 腹腔镜胰体尾切除术与开腹胰体尾切除术临床疗效对比[J]. 实用医学杂志, 2019, 35(16): 2560-2563.
[2]	吴信, 尚显文, 张皓, 叶川, 宁旭, 杨龙, 杨丹, 袁代柱, 李钟辉. 3D打印技术在多学科协作脊柱肿瘤精准化、个性化手术治疗的应用[J]. 实用医学杂志, 2019, 35(16): 2592-2597.
[3]	黄雯洁, 黄若昆, 欧阳斐, 赵晶晶, 雷波, 吴明正, 张绍华. 内踝斜形截骨角度数字化分析与3D打印个性化截骨导板的临床运用[J]. 实用医学杂志, 2019, 35(16): 2673-2676.