CAJ | 학술논문

目的总结腹腔镜胰体尾切除术(laparoscopic distal pancreatectomy,LDP)的临床应用经验及手术策略.方法回顾性分析我院自2003年11月至2013年6月所施行110例LDP的临床资料.结果本组110例患者中2例中转开腹,其余均在腹腔镜下完成.腹腔镜保留脾脏胰体尾切除术33例,6例合并多脏器切除;联合脾脏切除75例,20例合并多脏器切除.本组110例平均手术时间203±54 min(70 ～410 min),平均术中出血量167 ±87 ml(30 ～800 ml);平均术后下床活动时间1.2±0.6d(1～4d),术后平均禁食时间2.1±1.2d(1～6d),术后住院时间7.3±3.8 d(3～35d).总体并发症发生率为17.3％,无围手术期死亡.胰瘘12例,胰瘘发生率为10.9％,其中1例经二次手术治愈,其余病例经保守治疗治愈.结论对于具有开腹胰体尾切除手术基础的术者,腹腔镜手术治疗胰腺体尾部占位性病变是安全可行的.
목적 총결복강경이체미절제술(laparoscopic distal pancreatectomy,LDP)적림상응용경험급수술책략.방법 회고성분석아원자2003년11월지2013년6월소시행110례LDP적림상자료.결과 본조110례환자중2례중전개복,기여균재복강경하완성.복강경보류비장이체미절제술33례,6례합병다장기절제;연합비장절제75례,20례합병다장기절제.본조110례평균수술시간203±54 min(70 ～410 min),평균술중출혈량167 ±87 ml(30 ～800 ml);평균술후하상활동시간1.2±0.6d(1～4d),술후평균금식시간2.1±1.2d(1～6d),술후주원시간7.3±3.8 d(3～35d).총체병발증발생솔위17.3％,무위수술기사망.이루12례,이루발생솔위10.9％,기중1례경이차수술치유,기여병례경보수치료치유.결론 대우구유개복이체미절제수술기출적술자,복강경수술치료이선체미부점위성병변시안전가행적.
Objective To summarize the clinical experience and operation strategy of laparoscopic distal pancreatectomy (LDP).Methods Data of 1 10 cases of laparoscopic distal pancreatectomy from November 2003 to June 2013 in our hospital were retrospectively analyzed.Results LDP procedure was completed successfully in 110 patients except 2 cases were converted to open surgery,including 33 cases of laparoscopic spleen-preserving distal pancreatectomy (LSPDP),75 cases of laparoscopic distal pancreatectomy plus splenectomy (LDPS).The mean operation time was 203 ± 54 min (70-410 min),the mean intraoperative blood loss was 167 ± 87 ml(30-800 ml),the mean postoperative off-bed time was 1.2 ± 0.6 d(1-4 d),the mean fasting time was 2.1 ± 1.2 days(1-6 d),the mean postoperative hospital stay was 7.3 ± 3.8 d (3-35 d),the rate of overall postoperative complication was 17.3 ％,including 12 cases of pancreatic fistula.There was no perioperative death.The rate of pancreatic fistula was 10.9％;One case was cured by reoperation,the others were cured by conservative therapy.Conclusions For surgeons experienced with open distal pancreas surgery,LDP is safe and feasible.