全腹腔镜下保留十二指肠的胰头切除术治疗胰头囊腺瘤1例报道并文献复习

Total laparoscopic pancreatectomy with preservation of duodenum for the treatment of pancreatic cystadenoma: a case report and literature review

目的:探讨腹腔镜下保留十二指肠胰头切除术的安全性、可行性及其临床价值。方法:以我院收治的1例行腹腔镜下保留十二指肠的胰头切除术治疗胰头浆液性囊腺瘤的患者为研究对象,并通过查阅相关文献,对腹腔镜下保留十二指肠的胰头切除术的发展历史、优势、手术适应症、手术要点及难点进行综合分析。结果:本例患者手术过程顺利,手术时间245 min,术中出血200 mL,术后并发B级胰瘘,无其他并发症。结论:腹腔镜下保留十二指肠胰头切除术,技术上安全可行,且能达到传统开放胰腺手术相似的治疗效果,且损伤更小,术后恢复更快,具有微创优势。但关于腹腔镜保留十二指肠胰头切除术临床疗效,目前尚缺乏大宗病例的报道。故未来仍需高质量的前瞻性临床研究来验证腹腔镜保留十二指肠胰头切除术临床疗效的优越性。

Objective:To investigate the safety,feasibility and clinical value of laparoscopic resection of duodenopancreatic head.Methods:A case of pancreatic head resection with preservation of duodenum under laparoscopy for the treatment of serous cystadenoma of pancreatic head was studied.The history,advantages,indications,key points and difficulties of laparoscopic pancreatectomy with duodenal preservation were analyzed.Results:The operation process of this case was smooth,the operation time was 245 minutes,the intraoperative bleeding was 200 mL,and the postoperative pancreatic fistula was grade B.There were no other complications.Conclusions:Combined with this case and the relevant literature,it is believed that laparoscopic duodenopancreatectomy is technically safe and feasible,and can achieve the similar therapeutic effect of traditional open pancreas surgery,and the injury is less.The postoperative recovery is faster and has the advantage of minimally invasive.However,due to the clinical effect of laparoscopic duodenopancreatectomy,there are few reports of a large number of cases.Therefore,high-quality prospective clinical studies are still needed to verify the superiority of laparoscopic duodenopancreatectomy.