腹腔镜下胰体尾癌根治性顺行模块化胰脾切除术(附6例报告)

Preliminary experience of laparoscopic radical antegrade modular pancreatosplenectomy for carcinoma of pancreatic body and tail: with a report of 6 cases

目的:探讨腹腔镜根治性顺行模块化胰脾切除术(laparoscopic radical antegrade modular pancreatosplenectomy,LRAMPS)治疗胰体尾癌的临床应用。方法:2016年1月至2017年12月为6例术前诊断为胰腺体尾癌的患者行LRAMPS。结果:6例均在完全腹腔镜下完成手术,手术时间150～245 min,中位手术时间160 min;出血量100～200 m L,中位出血量110 m L;术后住院10～15 d,术后中位住院时间12 d。术后2例发生胰瘘,经保守治疗痊愈。结论:在熟练腹腔镜操作技术、开腹根治性顺行模块化胰脾切除术手术经验的保障下,开展LRAMPS是安全、可行的。

To explore the clinical application of laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS)in the treatment of pancreatic body and tail cancer.Methods:From Jan.2016 to Dec.2017,six patients with pancreatic body and tail cancer were treated by LRAMPS and their clinicopathological data were summarized.Results:All six patients were successfully treated with totally laparoscopic surgery.The median operation time was 160 min(range,150-245 min)and the median intraoperative blood loss was 110 mL(range,100-200 mL).The median postoperative hospitalization time was 12 d(range,10-15 d).Pancreatic fistula was found in two patients after operation and cured after conservative treatment.Conclusions:LRAMPS is safe and feasible when performed by the team with the experience of laparoscopic procedure and open radical antegrade modular pancreatosplenectomy.