CAJ | 학술논문

目的：系统评价微创及开腹胰十二指肠切除术的围术期安全性。方法以 Cochrane 系统评价方法，计算机检索 CNKI、万方、PubMed 数据库，检索时间1990年1月-2014年12月，收集微创胰十二指肠切除术和传统开腹手术围术期安全性的对比研究。采用软件 Rev Man 5.0对数据进行 Meta 分析。结果共纳入7个临床试验，557例患者。微创组与开腹组手术时间、术中出血量及住院时间的差异有统计学意义(P ＜0.05)，而术后胰瘘发生率、胃排空障碍发生率和术后死亡率的差异无统计学意义(P ＞0.05)。结论微创胰十二指肠切除术与传统开腹手术同样安全可行，微创手术具有术中出血少、疼痛轻、恢复快、住院时间短等优点，有良好的发展前景。
목적：계통평개미창급개복이십이지장절제술적위술기안전성。방법이 Cochrane 계통평개방법，계산궤검색 CNKI、만방、PubMed 수거고，검색시간1990년1월-2014년12월，수집미창이십이지장절제술화전통개복수술위술기안전성적대비연구。채용연건 Rev Man 5.0대수거진행 Meta 분석。결과공납입7개림상시험，557례환자。미창조여개복조수술시간、술중출혈량급주원시간적차이유통계학의의(P ＜0.05)，이술후이루발생솔、위배공장애발생솔화술후사망솔적차이무통계학의의(P ＞0.05)。결론미창이십이지장절제술여전통개복수술동양안전가행，미창수술구유술중출혈소、동통경、회복쾌、주원시간단등우점，유량호적발전전경。
Objective To evaluate the safety of minimally invasive surgery and open surgery on the prognosis of pancreaticoduodenectomy. Methods Database including CNKI, WanFang and PubMed (from January 1990 to December 2014) were searched to collect articles on comparing the safety of minimally invasive pancreaticoduodenectomy with open pancreaticoduodenectomy. The Cochrane network RevMan 5.0 software was used for Meta - analysis. Results A total of 7 articles with 557 patients were included. The Meta-analysis showed significant differences in operative time, estimated blood loss and length of hospital stays between minimally invasive pancreaticoduodenectomy group and open pancreaticoduodenectomy group (P <0.05). There was no significant difference in pancreatic fistula, delayed gastric empty and mortality between two groups (P > 0.05). Conclusion Minimally invasive pancreaticoduodenectomy is as safe and feasible as open pancreaticoduodenectomy, and it has the advantages of less bleeding, milder pain, faster recovery and shorter hospital stay.