三维可视化技术在腹腔镜保脾胰体尾切除手术中的应用

Three-dimensional visualization technology in the use of laparoscopic spleen-preserving distal pancreatectomy

目的探讨三维可视化技术在腹腔镜保脾胰体尾良性及低度恶性肿瘤切除术中的临床应用价值。方法回顾性分析北京医院2016年8月至2021年12月28例腹腔镜胰体尾切除手术患者的临床资料。结果3D组12例、对照组16例患者成功施行腹腔镜胰体尾肿瘤切除手术,3D组保脾胰体尾切除手术12例,对照组保脾胰体尾切除手术5例、联合脾切除的胰体尾切除11例。3D组的保脾手术率高于对照组,差异有统计学意义(P<0.05);3D组的手术时间[(202±53.8)min比(186.8±48.3)min]、术中出血量[(107.5±141.2)ml比(160.6±184.4)ml]、术后胰漏发生率与对照组差异无统计学意义(均P>0.05)。术后平均住院时间[(9.6±2.5)d比(19.1±40.6)d]差异亦无统计学意义(P>0.05)。结论三维可视化技术可提高腹腔镜胰体尾良性及低度恶性肿瘤切除术保脾的成功率和安全性。

Objective To evaluate three-dimensional visualization technology(3D technic)used in laparoscopic spleen-preserving distal pancreatectomy for pancreatic benign or low-grade malignant tumors.Methods Data of 28 patients with laparoscopic distal pancreatectomy at Beijing Hospital from Aug 2016 to Dec 2021 were retrospectively analyzed.Results There were 12 patients assigned in 3D attempt compared to 16 patients undergoing ordinary laparoscopy.In 3D group,all 12 patients underwent successful spleen preserving distal pancreatectomy.While in control group only 5 cases were successful in spleen preserving procedure,the remaining 11 cases failed in spleen preserving ending up in distal pancreatectomy combined with splenectomy.The spleen preserving pancreatectomy rate in 3D group was higher than control group(P<0.05).There was no significant difference in the operation time(202±53.8)min vs.(186.8±48.3)min,intraoperative blood loss(107.5±141.2)mL vs.(160.6±184.4)ml and the incidence of pancreatic leakage between the two groups(P>0.05).Nor there was difference in the average postoperative hospital stay between the two groups[(9.6±2.5)d vs.(19.1±40.6)d](P>0.05).Conclusion Three dimensional visualization technology can improve the success rate and safety of laparoscopic spleen preserving distal pancreatectomy in cases of benign and low-grade malignant distal pancreatic tumors.