全腹腔镜胰十二指肠切除术与传统开放手术治疗胰腺恶性肿瘤的近期疗效分析

Short-term outcomes of totally laparoscopic pancreaticoduodenectomy and traditional open surgery for malignant pancreatic tumors

目的:探讨完全腹腔镜与开放胰十二指肠切除术治疗胰腺恶性肿瘤的近期疗效。方法:回顾分析2016年9月至2021年9月施行的79例完全腹腔镜胰十二指肠切除术(TLPD)与97例开放胰十二指肠切除术(OPD)患者的临床资料,其中TLPD组中女41例,男38例,平均(60.8±20.2)岁;OPD组中女38例,男59例,平均(59.4±19.0)岁。对比分析两组术前、术中与术后近期相关指标。结果:TLPD组手术时间[(172.3±47.5)min vs.(196.0±62.1)min,P=0.004]、术中出血量[(192.1±25.2)mL vs.(380.7±76.9)mL,P<0.0001]、下床活动时间[(2.0±0.7)d vs.(3.1±1.1)d,P<0.0001]、排气时间[(4.0±0.5)d vs.(5.7±0.2)d,P<0.0001]、进食时间[(4.8±0.8)d vs.(5.7±1.5)d,P<0.0001]、引流管拔除时间[(9.4±0.9)d vs.(10.3±2.8)d,P=0.001]优于OPD组,差异有统计学意义;两组术后胰瘘、胆漏、切口感染等发生率差异无统计学意义。结论:TLPD治疗胰腺恶性肿瘤的近期疗效优于OPD。

Objective:To investigate the recent efficacy of totally laparoscopic pancreaticoduodenectomy compared with open pancreaticoduodenectomy in the treatment of malignant pancreatic tumors.Methods:This analysis reviewed clinical data of 79 patients who underwent totally laparoscopic pancreaticoduodenectomy(TLPD)and 97 patients who underwent open pancreaticoduodenectomy between Sep.2016 and Sep.2021.There were 41 females and 38 males in the TLPD group with the average age(60.8±20.2)years,and 38 females and 59 males in the OPD group with the age of(59.4±19.0)years.The preoperative,intraoperative and recent post-operative indicators of the patients in both groups were compared and analyzed.Results:In the TLPD group,the operative time[(172.3±47.5)min vs.(196.0±62.1)min,P=0.004],intraoperative blood loss[(192.1±25.2)mL vs.(380.7±76.9)mL,P<0.0001],ambulation time[(2.0±0.7)d vs.(3.1±1.1)d,P<0.0001],venting time[(4.0±0.5)d vs.(5.7±0.2)d,P<0.0001],feeding time[(4.8±0.8)d vs.(5.7±1.5)d,P<0.0001],and drainage tube removal time[(9.4±0.9)d vs.(10.3±2.8)d,P=0.001]were better than those in the OPD group,with statistically significant differences;the incidence of postoperative pancreatic fistula,biliary leakage,and incisional infection were not statistically significantly different between the two groups.Conclusions:TLPD is superior to OPD in terms of recent efficacy in the treatment of malignant pancreatic tumors.