腹腔镜胰体尾切除术的临床疗效分析

Clinical effectiveness analysis of laparoscopic distal pancreatectomy

目的:探讨腹腔镜胰体尾切除术的优越性,并分析术后胰瘘的原因。方法:回顾分析2017年1月至2018年12月为40例患者行胰体尾切除术的临床资料,依据手术方式分为开腹组与腔镜组。结果:40例患者中13例行腹腔镜手术,1例中转开腹,26例行开腹手术。腔镜组与开腹组手术时间、术中出血量、术后胰瘘发生率差异无统计学意义;腔镜组术后进食时间、术后住院时间、住院费用优于开腹组。胰瘘患者与非胰瘘患者年龄、性别、BMI、病理类型、胰腺残端是否加固缝合差异无统计学意义;胰瘘患者术前血淀粉酶高于非胰瘘患者。结论:腹腔镜胰体尾切除术可加快患者术后康复,降低住院费用,值得临床推广。对于术前血淀粉酶较高的患者,需关注其术后胰瘘的风险。

Objective:To investigate the superiority of laparoscopic distal pancreatectomy and analyze the reasons of postoperative pancreatic fistula.Methods:The clinical data of 40 patients who underwent distal pancreatectomy from Jan.2017 to Dec.2018 were retrospectively analyzed.According to the surgical procedure,they were divided into open group and laparoscopic group.Results:Of the 40 patients,13 underwent laparoscopic surgery,26 underwent open surgery,1 was converted to laparotomy.There was no significant difference in the operation time,intraoperative blood loss,or postoperative pancreatic fistula between the two surgical methods.The postoperative eating time,postoperative hospital stay and hospitalization costs in laparoscopic group were significantly better than those in open group.According to the analysis of pancreatic fistula after operation,it is found that the patient’s age,gender,BMI,pathological type,and whether the pancreatic stump is reinforced or not were not significantly different between the patients with or without pancreatic fistula;preoperative blood amylase in pancreatic fistula patients was higher than that in patients without pancreatic fistula.Conclusions:Laparoscopic distal pancreatectomy could accelerate postoperative rehabilitation and reduce hospitalization costs,is worthy of clinical promotion.Preoperative higher blood amylase should be paid attention for the risk of postoperative pancreatic fistula.