腹腔镜与开腹胰十二指肠切除术的短期效果对比

Short-term outcomes of laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy

目的比较腹腔镜胰十二指肠切除术(laparoscopic pancreaticoduodenectomy,LPD)与开腹胰十二指肠切除术(open pancreaticoduodenectomy,0PD)短期应用效果。方法回顾性分析2017年6月至2019年6月收治的85例LPD及同期103例0 P D患者临床资料,比较两组在围手术期的临床疗效。结果两组一般资料及术前资料差异均无统计学意义(P>0.05)。与0 P D组相比,LPD组手术时间较长[(407.6±117.4)m in比(220.8±23.9)min](P<0.05),但其术中出血量更少[(285.1±21.9)ml比(550.5±65.5)m l](P<0.05),术中淋巴结清扫数目更多[(13.5±1.4)个比(8.8±0.6)个](P<0.05),术后进流食时间更早(P<0.05),术后镇痛时间更短、住院天数更少(P<0.05)。术后胰瘘、胆瘘、胃瘫、腹腔出血等并发症发生率差异无统计学意义(P>0.05)。结论LPD与0PD—样安全可靠,围手术期临床效果相当,LPD出血少,术后康复更快。

Objective To compare the short-term outcomes of patients undergoing laparoscopic pancreaticoduodenectomy(LPD)and those with open pancreaticoduodenectomy(open pancreatiloduodenectomy,OPD).Methods The clinical data of 85 patients with LPD and 103 patients with OPD at our hospital from Jun 2017 to Jun 2019 were analyzed retrospectively.Results There was no significant difference in clinical data and between the two groups(P>0.05).Compared with OPD group,the operation time in LPD group was longer[(407.6±117.4)min vs.(220.8±23.9)min](P<0.05),but the intraoperative blood loss was less[(285.1±21.9)ml ][(550.5±65.5)ml](P<0.05).There was more lymph node dissection(13.5±1.4 n 8.8±0.6)(P<0.05),earlier feeding per month(P<0.05),shorter time for the use of analgesia and hospital stay(P<0.05).There was no significant difference in the incidence of postoperative complications such as pancreatic fistula,biliary fistula,gastroparesis and intra abdominal bleeding(P>0.05).Conclusions LPD is as safe and reliable as OPD,LPD has the advantages of more precise display during operation,while less traumatic and quicker recovery after operation.