腹腔镜与开腹胰十二指肠切除术治疗胰腺肿瘤的手术相关指标及患者生活质量和生活能力比较

Comparison of Surgery Related Indexes and Improvements of Patients’Quality of Life and Living Ability between Laparoscopic Surgery and Open Pancreaticoduodenectomy in the Treatment of Pancreatic Tumors

目的 比较腹腔镜辅助与传统开腹胰十二指肠切除术治疗胰腺肿瘤的手术相关指标,以及两种术式对患者生活质量和生活能力的影响.方法 将2018年3月—2020年7月在盘锦市中心医院接受胰十二指肠切除术治疗的89例胰腺肿瘤患者纳入研究,按照治疗方式的不同分为研究组49例和开腹组40例.开腹组实施开腹胰十二指肠切除术治疗,研究组行腹腔镜辅助胰十二指肠切除术治疗.比较分析两组手术相关指标、术后并发症发生情况,以及手术前后患者生活质量、生活能力和血清胆红素变化情况.结果 研究组手术时间长于开腹组、术中失血量少于开腹组、术后住院康复时间和进食时间短于开腹组,差异均具有统计学意义(P均<0.05).研究组术后并发症总发生率低于开腹组,差异具有统计学意义(P<0.05).两组术后生活质量、生活能力和血清胆红素水平均较术前得到改善,且研究组上述指标均优于开腹组,差异均具有统计学意义(P均<0.05).结论 腹腔镜辅助胰十二指肠切除术治疗胰腺肿瘤,较传统开腹手术具有较多优势,患者术后并发症发生率较低,且能够进一步改善患者的生活质量和生活能力.

Objective To compare the surgery related indexes between laparoscopic surgery and traditional open pancreaticoduodenectomy in the treatment of pancreatic tumors,as well as the impact of the two surgical methods on the quality of life and living ability of patients.Methods A total of 89 pancreatic tumors patients receiving pancreaticoduodenectomy in Panjin Central Hospital from March 2018 to July 2020 were included.The patients were divided into study group with 49 cases and open group with 40 cases according to the different treatment methods.The open group were treated with open pancreaticoduodenectomy,while the study group were treated with laparoscopic pancreaticoduodenectomy.The surgery-related indicators,the occurrence of postoperative complications,and the changes of the patients’quality of life,living ability and serum bilirubin before and after the operation between two groups were compared and analyzed.Results The operation time of the study group was significantly longer than that of the laparotomy group,the blood loss during the operation was significantly less than that of the laparotomy group,and the postoperative hospital recovery time and initiation of oral intake were significantly shorter than that of the open group(P<0.05).The total incidence of postoperative complications in the study group was significantly lower than that in the open group(P<0.05).The postoperative quality of life,living ability and serum bilirubin level of the two groups were improved significantly compared with those before the operation(P<0.05).Conclusion Laparoscopic-assisted pancreaticoduodenectomy has more advantages and low incidence of postoperative complications than traditional open surgery in the treatment of pancreatic tumors,and can further improve the quality of life and activities of daily living of patients.