腹腔镜胰体尾切除术与开腹胰体尾切除术临床疗效对比

doi:10.3969/j.issn.1006-5725.2019.16.010

实用医学杂志 ›› 2019, Vol. 35 ›› Issue (16): 2560-2563.doi: 10.3969/j.issn.1006-5725.2019.16.010

腹腔镜胰体尾切除术与开腹胰体尾切除术临床疗效对比

胡欢欢, 钟志惟, 宁克, 王超, 袁春晖, 殷香保

南昌大学第二附属医院肝胆胰外科（南昌 330006）

收稿日期:2019-03-13 出版日期:2019-08-27 发布日期:2019-08-27
通讯作者: 殷香保 E-mail：yxb115@sina.com
基金资助:
国家自然科学基金项目（编号：81760439）

Comparison of clinical efficacy of laparoscopic distal pancreatic resection and open distal pancreatic resection

HU Huanhuan, ZHONG Zhiwei, NING Ke, WANG Chao, YUAN Chunhui, YIN Xiangbao

Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

Received:2019-03-13 Online:2019-08-27 Published:2019-08-27
Contact: YIN Xiangbao E-mail： yxb115@sina.com

摘要/Abstract

摘要： 目的对腹腔镜胰体尾切除术（laparoscopic distal pancreatectomy,LDP）与开腹胰体尾切除术（open distal pancreatectomy,ODP）的治疗效果进行比较分析,并探讨LDP的优缺点。方法回顾性分析2014年1月至2018年4月在南昌大学第二附属医院施行的22例LDP患者与20例ODP患者的临床资料,对两组患者的手术及术后情况进行比较分析。结果两组患者均顺利完成胰体尾切除术。在术中出血量上,LDP组少于ODP组[（155.63 ± 39.26） mL vs. （255.42 ± 118.63） mL,P < 0.05];术后禁食时间分别（4.21 ± 0.92）d和（4.68 ± 0.76）d,肛门排气时间分别为（2.26 ± 0.73）d和（2.87 ± 0.52）d ,住院时间分别为（9.27 ± 3.68）d和（12.31 ± 4.73）d,LDP组较ODP缩短,差异均具有统计学意义（P < 0.05 ）;在手术时间上,LDP组长于ODP组[（258.32 ± 42.52 ）min vs.（186.56 ± 34.28 ）min,P < 0.05];LDP组和ODP组的保脾率和术后并发症发生率差异无统计学意义（P > 0.05 ）。LDP组和ODP组术后病理结果均显示标本切缘为阴性。结论 LDP是安全有效的,外科疗效与ODP相当,短期预后效果明显高于ODP,值得在临床上推广应用。

关键词: 腹腔镜胰体尾切除术, 开腹胰体尾切除术, 胰腺肿瘤

Abstract: Objective To compare the clinical efficacy of laparoscopic distal pancreatectomy （LDP） and open distal pancreatectomy （ODP）. To investigate the advantages and disadvantages of LDP. Methods The clinical data of 22 patients undergone LDP and 20 patients undergone ODP at the Second Affiliated Hospital of Nanchang University from January 2014 to April 2018 were analyzed retrospectively. Results Both groups of patients successfully completed the distal pancreatectomy. Intraoperative blood loss in LDP group were less than that in ODP group [（155.63 ± 39.26）mL vs.（255.42 ± 118.63）mL,P < 0.05]. The postoperative fasting time （4.21 ± 0.92）d vs. （4.68 ± 0.76）d, anal exhaust time （2.26 ± 0.73）d vs. （2.87 ± 0.52）d and hospital stays （9.27 ± 3.68） d vs. （12.31 ± 4.73）d in LDP group were shorter than that in ODP group （all P < 0.05）.Surgery duration in LDP were longer than ODP [（258.32 ± 42.52） min vs.（186.56 ± 34.28）min, P < 0.05]. There was no statistically significant difference in the rates of spleen-preserving and incidence of postoperative complication between two groups （P > 0.05）. The pathological Results of LDP group and ODP group showed that the specimen margins were negative. Conclusion LDP is safe and effective. Its surgical efficacy is equal to ODP. The short-term efficacy of LDP is significantly better than that of ODP, so it deserves to be promoted in clinical practice.

Key words: laparoscopic distal pancreatic resection, open distal pancreatic resection, pancreatic tumor

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.

HU Huanhuan, ZHONG Zhiwei, NING Ke, WANG Chao, YUAN Chunhui, YIN Xiangbao. Comparison of clinical efficacy of laparoscopic distal pancreatic resection and open distal pancreatic resection[J]. The Journal of Practical Medicine, 2019, 35(16): 2560-2563.

参考文献 19

[1]	SIDDAIAH-SUBRAMANYA M, TIANG K, NYANDOWE M.A new era of minimally invasive surgery: Progress and development of major technical innovations in general surgery over the last decade[J]. Surg J (N Y), 2017, 3(4):e163-e166.
[2]	CUSCHIERI A, JAKIMOWICZ J J, VAN SPREEUWEL J.Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis[J]. Ann Surg,1996,223(3):280-285.
[3]	中华医学会外科学分会胰腺外科学组,中国研究型医院学会胰腺病专业委员会,中华外科杂志编辑部.胰腺术后外科常见并发症诊治及预防的专家共识(2017)[J]. 中华外科杂志,2017,55(5):328-334.
[4]	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.
[5]	JARUFE N, SOTO P, AHUMADA V, et al.Laparoscopic versus open distal pancreatectomy: Comparative analysis of clinical outcomes at a single institution[J]. Surg Laparosc Endosc Percutan Tech,2018,28(1):62-66.
[6]	DE ROOIJ T, KLOMPMAKER S, ABU HILAL M, et al.Laparoscopic pancreatic surgery for benign and malignant disease[J]. Nat Rev Gastroenterol Hepatol,2016,13(4):227-238.
[7]	楼文晖,方圆. 胰腺癌根治术的范围:共识与争议[J].中国实用外科杂志, 2018,38(2): 146-148.
[8]	DOKMAK S, FTERICHE F S, AUSSILHOU B, et al.The largest european single-center experience: 300 laparoscopic pancreatic resections[J]. J Am Coll Surg, 2017, 225(2): 226-234.
[9]	KOOBY D A, HAWKINS W G, SCHMIDT C M, et al.A multicenter analysis of distal pa nereateetomy for adis lapenoeareinoma: Is laparoscopie resection appropriate?[J]. J Am Coil Surg,2010,210(5 ):779-787.
[10]	STAUFFER J A,COPPOLA A,MODY K,et al.Laparoscopic versus open distal pancreatectomy for pancreatic adenocarcinoma[J]. World J Surg,2016,40(6):1477-1484.
[11]	王栋,钟志惟,殷香保,等. 腹腔镜保脾胰体尾切除术的临床疗效[J]. 中华消化外科杂志,2018,17(12):1209-1214.
[12]	LI B Q, QIAO Y X, LI J, et al.Preservation or ligation of splenic vessels during spleen-preserving distal pancreatectomy: A meta-analysis[J]. J Invest Surg, 2018,11:1-16 [Epub ahead of print].
[13]	TEZCANER T, EKICI Y, AYDIN O H, et al.Laparoscopic spleen-preserving distal pancreatectomy for a primary hydatid cyst mimicking a mucinous cystic neoplasia[J]. J Minim Access Surg, 2016, 13(2):148-150.
[14]	DAI M H, SHI N, XING C, et al.Splenic preversation in laparoscopic distal pancreatectomy[J]. Br J Surg,2017,104(4):452-462.
[15]	CHAPMAN B C, PANICCIA A, RYAN C, et al.Laparoscopic spleen-preserving total pancreatectomy for a main-duct intraductal papillary mucinous neoplasm[J]. Ann Surg Oncol, 2016, 24(2):560.
[16]	吴志明,牟一平. 腹腔镜胰体尾切除术后胰漏的防治进展[J]. 中国微创外科杂志, 2016,16(6):566-569.
[17]	FAN Y, LIU Y Y, WANG P, et al.Study on the efficacies of splenic pedicle transection by using manual manipulation and Endo-GIA procedure for laparoscopic splenectomy[J]. Int J Clin Exp Med, 2015 ,8(10):19430-19435.
[18]	郑毅,白霞,许鑫,等. 腹腔镜胰体尾部切除术后并发症及其影响因素分析[J]. 临床肝胆病杂志,2017,33(10):1987-1989.
[19]	DINORCIA J, SCHROPE B A, LEE M K.Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications[J]. J Gastrointest Surg,2010 ,14(11):1804-1812.

腹腔镜胰体尾切除术与开腹胰体尾切除术临床疗效对比

Comparison of clinical efficacy of laparoscopic distal pancreatic resection and open distal pancreatic resection

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