中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2015年
7期
437-441
,共5页
彭淑牖%李江涛%秦仁义%刘颖斌%洪德飞%王建伟%王敏%吴文广%黄从云
彭淑牖%李江濤%秦仁義%劉穎斌%洪德飛%王建偉%王敏%吳文廣%黃從雲
팽숙유%리강도%진인의%류영빈%홍덕비%왕건위%왕민%오문엄%황종운
胰头癌%胰十二指肠切除术%胰腺全系膜切除%腹膜后淋巴脂肪板层根治性切除术
胰頭癌%胰十二指腸切除術%胰腺全繫膜切除%腹膜後淋巴脂肪闆層根治性切除術
이두암%이십이지장절제술%이선전계막절제%복막후림파지방판층근치성절제술
Pancreatic head carcinoma%Pancreaticoduodenectomy%Total mesopancreas excision%RRRLLL
目的 总结评价胰头癌行根治性胰十二指肠切除新策略——腹膜后淋巴脂肪板层根治性切除术(RRRLLL).方法 回顾性分析作者单位2012年1月至2015年2月,133例胰头癌患者采用RRRLLL的手术方式和临床资料.结果 133例患者中,门静脉-肠系膜上静脉血管侧壁切除修补和静脉切除端端吻合重建39例.平均手术时间288 min,平均出血量454 ml,平均术后排气时间6.2d,平均术后住院日13.2 d.31例(23.3％)发生术后并发症,其中肺部感染7例,胰漏(A级)6例,切口感染5例,胃排空障碍5例,胆漏4例,术后出血4例,术后腹泻2例,无围手术期死亡病例.结论 RRRLLL明确了胰头癌根治性胰十二指肠切除术的三维清扫空间范围,易于安全操作,是胰头癌切除理念的更新,对提高胰头癌手术的安全性和疗效具有重要意义.
目的 總結評價胰頭癌行根治性胰十二指腸切除新策略——腹膜後淋巴脂肪闆層根治性切除術(RRRLLL).方法 迴顧性分析作者單位2012年1月至2015年2月,133例胰頭癌患者採用RRRLLL的手術方式和臨床資料.結果 133例患者中,門靜脈-腸繫膜上靜脈血管側壁切除脩補和靜脈切除耑耑吻閤重建39例.平均手術時間288 min,平均齣血量454 ml,平均術後排氣時間6.2d,平均術後住院日13.2 d.31例(23.3％)髮生術後併髮癥,其中肺部感染7例,胰漏(A級)6例,切口感染5例,胃排空障礙5例,膽漏4例,術後齣血4例,術後腹瀉2例,無圍手術期死亡病例.結論 RRRLLL明確瞭胰頭癌根治性胰十二指腸切除術的三維清掃空間範圍,易于安全操作,是胰頭癌切除理唸的更新,對提高胰頭癌手術的安全性和療效具有重要意義.
목적 총결평개이두암행근치성이십이지장절제신책략——복막후림파지방판층근치성절제술(RRRLLL).방법 회고성분석작자단위2012년1월지2015년2월,133례이두암환자채용RRRLLL적수술방식화림상자료.결과 133례환자중,문정맥-장계막상정맥혈관측벽절제수보화정맥절제단단문합중건39례.평균수술시간288 min,평균출혈량454 ml,평균술후배기시간6.2d,평균술후주원일13.2 d.31례(23.3％)발생술후병발증,기중폐부감염7례,이루(A급)6례,절구감염5례,위배공장애5례,담루4례,술후출혈4례,술후복사2례,무위수술기사망병례.결론 RRRLLL명학료이두암근치성이십이지장절제술적삼유청소공간범위,역우안전조작,시이두암절제이념적경신,대제고이두암수술적안전성화료효구유중요의의.
Objective To evaluate a new strategy of Radical Resection of Retroperitoneal LipoLymphatic Layer (RRRLLL) for pancreatic cancer in pancreaticoduodenectomy(PD).Methods From January 2012 to February 2015,133 patients with pancreatic head adenocarcinoma underwent RRRLLL in PD,the data of surgical technique and clinical peri-operative results were analyzed.Results All the 133 patients underwent RRRLLL in pancreaticoduodenectomy.The mean operation time was 288 minutes,and the mean blood loss was 454 ml.39 patients underwent resection and repair of vessel lateral wall or end-to-end anastomosis of portal vein or super mesenteric vein.31 cases with postoperative complications (23.3％) and no mortality.The incidence rates of postoperative bleeding,pancreatic leakage,biliary leakage,delayed gastric emptying and diarrhea,were 3.0％,4.5 ％,3.0％,3.8％,and 1.5％ respectively.Conclusions As a new concept,RRRLLL depicts a definite area of dissection for PD.As a surgical procedure,it is relatively easy to perform.Difficult cases also can be tackled safely.This updated concept of PD is promising in terms of its effectiveness and safety.Further study is needed to confirm its radicalness.
