机器人辅助胰体尾切除术61例分析

Robot-assisted distal pancreatectomy： a study on 61 patients

目的评估机器人辅助胰体尾切除术的疗效，探讨机器人在胰体尾微创领域的应用经验及手术技巧。方法回顾性分析2013年7月至2017年6月长海医院行机器人辅助胰体尾切除术的63例患者资料，分析手术时间、术后并发症、住院时间等相关指标和手术技巧。结果除1例因腹腔广泛粘连中转开腹，1例行胰腺肿瘤局部切除外，其余61例患者均顺利完成手术。17例行保留脾脏的胰体尾切除术，44例行胰体尾脾脏切除术。手术平均耗时164．1min，术中出血平均153．7ml，1例患者术中输血400ml。术后胰瘘发生率45．9％，其中生化瘘发生率37．7％，B级瘘8．2％，没有C级瘘发生。结论机器人辅助胰体尾切除术安全可行，在保留脾脏方面也有一定优势。

Objective To study the effect of robot-assisted distal pancreatectomy. Methods 63 patients who were originally scheduled for robot-assisted distal pancreatectomy were vetrospectively analyzed from July 2013 to June 2017 in Changhai Hospital. Results The operations were successfully carried out in 61 patients. One patient was converted to open surgery because of extensive adhesions, and another patient underwent local excision of a pancreatic tumor. 17 patients underwent robot-assisted spleen-preserving distal pancreatectomy, and 44 patients robot-assisted distal splenopancreatectomy. The mean operative time was 164. 1 minutes. The intraoperative blood loss was 153.7 ml. Only l patient received 400 ml. of blood transfusion. The rate of postoperative pancreatic fistula was 45.9%. The rates of biochemical fistula and level B fistula were 37.7% and 8.2%, respectively. No level C fistula was observed. Conclusion Robot-assisted distal pancreateetomywas an efficacious and safe technique with its unique advantages in spleen-preserving operations.