目的总结腹腔镜保留十二指肠胰头切除术的经验。方法回顾性分析2016年4—5月浙江省人民医院肝胆胰外科4例行腹腔镜保留十二指肠的胰头切除术病人的临床资料。结果4例病人顺利完成手术。手术时间280—450min,术中出血250—600mL,术后并发A级胰瘘3例,无其他并发症。术后住院时间10~22d。术后病理学检查结果显示胰头部浆液性囊腺瘤2例,导管内分支型乳头状黏液瘤1例,神经内分泌肿瘤1例。结论腹腔镜保留十二指肠的胰头切除术治疗胰头部良性或低度恶性病变安全,有效、微创,值得临床推广应用。
Objective To investigate the role of laparoscopic duodenum-preserving subtotal pancreatic head resection (LDPPHR).Methods The clinical data of 4 cases of LDPPHR performed in Zhejiang Provincial People' s Hospital between April 2016 and May 2016 were reviewed retrospectively. Results Four cases underwent LDPPHR successfully. The mean operation time was 280-450 minutes, estimated blood loss was 250-600 mL and postoperative hospital stay was 10-22 days. Three cases had pancreatic fistula of grade A. Pathologic results showed intraductal papillary mucinous neoplasms in one case, serous cystadenoma in two cases and solid pseudopaillary neoplasm in one case. Conclusion The LDPPHR is safe and feasible to treat benign and low-grade malignance at high volume minimal invasive and pancreatic centers with minimal invasive advantage.