机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术

Robot-assisted in situ resection of intraductal papillary mucinous adenoma of pancreas combined with main pancreatic duct bridging

目的总结机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术的经验。方法回顾性分析2020年5月在解放军总医院肝胆胰外科医学部进行机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术患者的临床资料。结果患者顺利完成手术,镜下操作时间135 min,术中出血量约50 ml,术后6 d带引流管出院,术后18 d左右拔除引流管。术后病理考虑为导管内乳头状黏液腺瘤伴低级别上皮内瘤变。结论原位切除联合主胰管架桥修复术是一种新的手术方式和外科理念,在功能脏器保护的同时更注意生理解剖完整性的保护,通过主胰管架桥修复为核心技术的胰腺整形修复术还原人体正常解剖结构,显著提高患者生活质量。

Objective To summarize the experience of robot assisted in situ resection of intraductal papillary mucinous adenoma of the pancreas combined with main pancreatic duct bridging.Methods The clinical data of patients who underwent in situ resection of pancreatic intraductal papillary mucinous adenoma combined with main pancreatic duct bridge repair in May 2020 in the Department of Hepatobiliary Pancreatic surgery,General Hospital of Chinese PLA were retrospectively analyzed.Results The patient successfully completed the operation.The operation time was 135 minutes under the microscope,and the blood loss was about 50 ml.the drainage tube was discharged 6 days after the operation,and the drainage tube was removed about 18 days after the operation.Intraductal papillary myxoma with low grade intraepithelial neoplasia was considered pathologically.Conclusions In situ resection combined with main pancreatic duct bridge repair is a new surgical method and surgical concept.While protecting the functional organs,more attention should be paid to the protection of physiological and anatomical integrity.Through the main pancreatic duct bridge repair as the core technology of pancreatic plastic repair,the normal anatomical structure of human body can be reduced,and the quality of life of patients can be significantly improved.