腹腔镜胃镜联合治疗胃十二指肠良性肿瘤

Laparoscopy combined with gastroscopy for gastroduodenal benign tumor

目的探讨应用胃镜术中定位联合腹腔镜治疗胃十二指肠良性肿瘤的临床价值。方法对腹腔镜外科治疗胃十二指肠良性肿瘤术中难以定位的患者,应用术中胃镜定位技术,共治疗胃良性肿瘤11例、十二指肠良性肿瘤2例。结果 11例在双镜联合下顺利找到肿瘤并成功行局部切除,无并发症。手术时间50～98 min,平均69 min,出血约20～100 ml,术后2～4 d 恢复流质饮食,平均住院时间5.7 d;1例术中胃镜下病灶隐匿,分离胃小弯侧系膜后在单纯腹腔镜下找到肿瘤并切除;另1例为 LC 术后1年患者,超声内镜提示十二指肠球部占位,术中未发现肿瘤。结论应用腹腔镜及胃镜联合治疗胃十二指肠良性肿瘤具有定位准确迅速、缩短手术时间、手术创伤小、术后疼痛轻、恢复快等优点,具有良好的应用价值。

Objective To investigate the clinical values of laparoseopy combined with gastroscopy for treating gastroduodenal benign tumors. Methods Thirteen cases which were hard in localizing the gastroduodenal benign tumor during laparoscopy received laparoscopy combined with gastroscopy. Among them, 11 cases have gastric benign tumors and two cases, duodenal benign tumors. Results Gastroduodenal benign tumors in eleven cases were locally resected under laparoscopy combined with gastroseopy successfully without any complication. The average operation time was 69 minutes （range 50 minutes to 98 minutes） , blood loss during operation procedure was 20 - 100 ml. All patients were able to have liquid food within 2 4 days after operation. The average postoperative hospital stay was 5.7days. One case was hard to localize the tumor under gastroscopy during operation, after separating the adherent tissue of lesser gastric curvcature ; the tumor was found and removed merely under laparoscopy. Another case was suspected to have neoplasm in duodenal bulb by ultrasonic endoscopy one year after LC, was not confirmed during operation. Conclusion This procedure using laparoseopy combined with gastrocopy for treating gastroduodenal benign tumors is reliable and effective in clinical application, due to the advantages of accurate and quick localization of tomour, shortened the operation time, and minimal injury to patients with fast recovery.