机器人LR式1+2胰肠吻合方法的理论与技巧:附104例病例报道

Technique and theory of LR's 1+2 pancreaticojejunostomy in robotic pancreatectomy:an analysis of 104 cases

目的介绍一种新的机器人LR式1+2胰肠吻合方法。方法回顾性分析解放军总医院2016年3月至2017年1月由单一主刀完成的机器人胰十二指肠切除或中段胰腺切除术的临床资料。结果研究共纳入104例患者,其中机器人胰十二指肠切除术93例,机器人胰腺中段切除术11例。术中胰肠吻合采用1+2胰肠吻合方法。胰管估算直径0.8~15.0 mm,平均胰肠吻合时间(14.5±5.5)min(10.0~28.0 min)。术后B级以上胰瘘发生率8.6%,平均住院时间(13.6±5.1)d。结论机器人下1+2胰肠吻合方法化繁为简,吻合安全可靠,胰瘘发生率低,值得临床推广,本方法同样适用于开腹。

Objective Introduce a novel LR＇s 1 ＋ 2 panereaticojejunostomy in robotic pancreatectomy. Methods A consecutive series of patients who underwent robotic pancreaticoduodenectomy and middle segment pancreatectomy by a single surgeon were selected between Mar. 2016 and Jan. 2017. Results 104 patients were enrolled in this study, 1 ＋ 2 pancreaticojejunostomy were successfully performed in 93 cases of robotic pancreaticoduodeneetomy and 11 cases of central pancreatectomy, respectively. The estimated diameter of main pancreatic duct was 0. 8-15. 0 mm, mean time of pancreaticojejunostomy procedure was （ 14.5 ±5.5 ） min （ 10.0-28.0 min） , and the mean postoperative hospital stay was（ 13.6 ± 5.1 ）d. Additionally, the postoperative pancreatic fistula （Grade B and C） was 8.6%. Conclusions The 1 ＋ 2 pancreaticojejunostomy approach is convenient, safe and reliable for robotic pancreaticoduodenectomy and central pancreatectomy, which could also been used in open procedure.