腹腔镜胰腺中段切除术5例经验总结并文献复习

Laparoscopic central pancreatectomy:a report of 5 cases and literature review

目的:探讨腹腔镜胰腺中段切除术的安全性及手术操作经验。方法:回顾分析2020年7月至2022年4月施行腹腔镜胰腺中段切除术的5例患者的临床资料,评价临床疗效及预后效果。结果:5例患者中男2例,女3例,平均(39.40±16.04)岁。5例患者均顺利完成腹腔镜胰腺中段切除术,手术时间平均(283.60±23.80)min,术中出血量平均(122.00±73.28)mL。术中行腹腔淋巴结病理检查均未见肿瘤,术后平均住院(10.00±1.58)d。术后4例患者发生生化漏;1例因引流液较浑浊,经腹水淀粉酶测量诊断为胰瘘;未发生腹腔出血等严重并发症,并发症均通过保守治疗治愈。术后病理示2例为浆液性囊腺瘤,2例为胰腺实性假乳头状瘤,1例为胰腺神经内分泌肿瘤。胰腺功能重建方式均为胰肠Roux-en-Y吻合。结论:对于胰腺颈、体部的良性或低度恶性肿瘤,腹腔镜胰腺中段切除术是安全、可行的。

Objective:To investigate the safety and surgical experience of laparoscopic central pancreatectomy.Methods:The clinical data of 5 patients who underwent laparoscopic central pancreatectomy from Jul.2020 to Apr.2022 were retrospectively analyzed,and the clinical efficacy and prognosis were evaluated.Results:There were 2 males and 3 females.The average age was(39.40±16.04)years.All 5 patients successfully completed laparoscopic central pancreatectomy.The average operation time was(283.60±23.80)min.The average intraoperative blood loss was(122.00±73.28)mL.No tumor was found by intraoperative pathological examination of abdominal lymph nodes in all patients.The average postoperative hospital stay was(10.00±1.58)d.Biochemical leakage occurred in 4 patients,and 1 patient with turbid drainage fluid was diagnosed with pancreatic fistula by the measurement of ascites amylase.No serious complications such as abdominal hemorrhage occurred and all complications were cured by conservative treatment.Postoperative pathology showed that 2 cases were serous cystadenomas,2 were pancreatic solid pseudopapilloma,and 1 was pancreatic neuroendocrine tumor.Pancreatic function reconstruction was performed by Roux-en-Y pancreatoenterostomy.Conclusions:Laparoscopic central pancreatectomy is a safe and feasible surgical method for patients with benign or low-grade malignant tumors in the neck and body of the pancreas.