CAJ | 학술논문

目的探讨腹腔镜辅助下行胰十二指肠切除的可行性。方法收集2010年1月至5月行腹腔镜辅助下胰十二指肠切除术的5例患者。其中2例术前诊断为胆总管下端腺癌，2例为十二指肠降部腺癌，l例术中诊断为胰头癌。术中首先行腹腔镜探查，在腹腔镜下分离并切除胆囊、远端胆管、远端胃、十二指肠、部分空肠及胰头，然后再剖腹完成消化道重建。结果 5例患者手术顺利，手术时间平均为(339 t54) min，术中出血量平均为(538 t106) ml，术中无输血；术后平均(4.0±l.O)d恢复肠道功能，术后(15.8 t4.7)d出院；一例发生胰瘘，经非手术治疗后愈合。结论腹腔镜辅助下胰十二指肠切除术具有微创、手术时间短、术后恢复快等优点，值得临床上进一步探讨。
목적 탐토복강경보조하행이십이지장절제적가행성。방법 수집2010년1월지5월행복강경보조하이십이지장절제술적5례환자。기중2례술전진단위담총관하단선암，2례위십이지 장강부선암，l례술중진단위이두암。술중수선행복강경탐사，재복강경하분리병절제담낭、원단담관、 원단위、십이지장、부분공장급이두，연후재부복완성소화도중건。결과 5례환자수술순리，수술시간 평균위(339 t54) min，술중출혈량평균위(538 t106) ml，술중무수혈；술후평균(4.0±l.O)d회복장도 공능，술후(15.8 t4.7)d출원；일례발생이루，경비수술치료후유합。결론 복강경보조하이십이지장 절제술구유미창、수술시간단、술후회복쾌등우점，치득림상상진일보탐토。
Objective To explore the feasibility of laparoscopic-assisted pancreaticoduodenectomy.Methods The clinical data of 5 patients in our hospital from January to May 2010 were analyzed. 2 patients were pre-operatively diagnosed to have lower common bile duct adenocarcinoma, and 2 patients were preoperatively diagnosed to have adenocarcinoma of the descending duodenum, 1 patient was intra-oparatively diagnosed to have pancreatic head cancer. During the operation, laparoscopic exploration was performed, then gallbladder, distant bile duct, distant stomach, duodenum, part of jejunum and head of pancreas were disassociated, then the digestive tract was reconstructed under open abdomen surgery. Results All the operations of the 5 cases were successfully performed, with an average operation time ( 339 ± 54) min and an intra-operative blood loss of (538 ± 106)ml, and there was no intra-operative blood transfusion. The patients'bowel function recovered (4.0 ± 1.0 ) d postoperatively and were discharged ( 15.8 ± 4.7 ) d postoperatively.1 patient developed pancreatic fistula and was cured with conservative treatment. Conclusions Laparoscopicassisted pancreatoduodenectomy is minimally invasive with short operation time and fast postoperative recovery,which is worth of further clinical study.