腹腔镜辅助胰十二指肠切除术的近期疗效观察

Short-term effect of laparoscopic-assisted pancreaticoduodenectomy

目的比较腹腔镜辅助胰十二指肠切除术(LAPD)与开腹胰十二指肠切除术(OPD)的近期疗效,探讨LAPD的手术安全性及可行性。方法回顾性分析2015年10月至2017年12月沧州市中心医院普外科施行的102例LAPD和179例OPD患者的临床资料,将两组各项临床数据进行对比分析。结果 LAPD组手术时间显著长于OPD组[(381±67)min vs (245±43)min],但LAPD组术中出血量更少[(186±102)mL vs(322±75)mL],手术切口更小[(8.1±3.9)cm vs (18.9±4.3)cm],术后进流食时间、术后ICU入住时间及术后住院时间均更短,两组比较差异均有统计学意义(P<0.05)。术中淋巴结清扫数目、R0切除率、术后并发症发生率及术后6个月无瘤生存率的差异均无统计学意义(P>0.05)。结论 LAPD具有与传统OPD手术相似的安全性和肿瘤根治效果,而且具有创伤小、恢复快等优势。但LAPD手术时间更长,对术者经验要求更高。

Objective To compare the short-term efficacy of laparoscopic-assisted pancreaticoduodenectomy (LAPD) with open pancreatoduodenectomy (OPD), and to investigate the safety and feasibility of LAPD. Methods The clinical data of 102 patients undergone LAPD and 179 patients undergone OPD treated in Cangzhou Central Hospital from Oct. 2015 to Dec. 2017 was analyzed retrospectively. The clinical data of the two groups was compared and analyzed. Results The operation time in LAPD group was significantly longer than that in OPD group [(381±67) min vs (245±43) min], but the bleeding volume in LAPD group was less [(186±102) mL vs (322±75) mL], the incision was smaller [(8.1±3.9) cm vs (18.9±4.3) cm], and postoperative feeding time, ICU duration and hospitalization were shorter (all P<0.05). There were no significant differences in number of lymph node dissection, R0 resection rate, postoperative complications and tumor-free survival rate at 6 months postoperative between the two groups (P>0.05). Conclusion LAPD has the same safety and radical effect as the traditional OPD surgery, and has the advantages of less trauma and quicker postoperative recovery. But the operation time for LAPD is longer and requires more experience for the surgeons.