保留胰腺功能的限制性胰腺切除术在良性及交界性肿瘤中临床应用研究

Clinical application of limited pancreatic resection with pancreatic function preservation in benign and borderline tumors

目的:研究保留胰腺功能的限制性胰腺切除术在良性及交界性肿瘤中的临床应用价值。方法:回顾性分析2020年1月至2022年9月手术治疗的86例胰腺良性及交界性肿瘤患者的临床资料。根据手术方式不同分为传统组(n=52)和保留组(n=34),传统组患者行传统的手术方式,保留组患者行保留胰腺功能的限制性胰腺切除术。数据应用软件SPSS 22.0处理。围手术期相关指标、术后生活质量等计量资料采用(^(-)x±s)表示,行独立样本t检验;术后并发症等计数资料采用[例(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果:两组患者手术时间、术中输血情况、术后排气时间及术后住院时间比较,差异无统计学意义(P>0.05),但保留组患者术中出血量显著低于传统组(P<0.05);两组患者术后胰瘘、切口感染、腹腔感染、出血、胃排空障碍等并发症比较,差异均无统计学意义(P>0.05);保留组患者的术后生活质量8项评分均显著高于传统组(P<0.05);术后中位随访时间16(6~38)个月,两组患者均无死亡病例,且两组患者在术后肿瘤复发(7.7%vs.2.9%)及转移(3.8%vs.2.9%)方面比较,差异无统计学意义(P>0.05),但保留组患者胰腺内、外功能受损发生率明显低于传统组(5.9%vs.23.1%,P=0.035)。结论:保留胰腺功能的限制性胰腺切除术在良性及交界性肿瘤中的应用安全可行,最大程度地保留了更多胰腺正常组织,减少了胰腺内、外分泌功能受损,并改善了患者术后生活质量。

Objective To investigate the clinical value of restricted pancreatectomy with preservation of pancreatic function in benign and borderline tumors.Methods The clinical data of 86 patients with benign and borderline pancreatic tumors treated by surgery from January 2020 to September 2022 were retrospectively analyzed.They were divided into traditional group(n=52)and reserved group(n=34)according to different operation methods.Traditional group:traditional operation was performed,and reserved group:restricted pancreatectomy was performed to preserve pancreatic function.The data was processed by SPSS 22.0.Perioperative relevant indicators and postoperative quality of life measurement data were represented by(^(-)x±s),and independent t test was performed.The statistical data of postoperative complications were represented by[n(%)]andχ^(2)test was performed.P<0.05 was considered statistically significant.Results There was no significant difference in operation time,intraoperative blood transfusion,postoperative exhaust time and postoperative hospitalization time between the two groups(P>0.05).The amount of blood loss in the retention group was significantly lower than that in the traditional group(P<0.05).There were no significant differences in postoperative complications such as pancreatic fistula,incision infection,abdominal infection,bleeding,and gastric empting disorder between the two groups(P>0.05).The 8 scores of postoperative quality of life in the retention group were significantly higher than those in the traditional group(P<0.05).After a median follow-up of 16(6~38)months,there were no deaths between the two groups,and there was no significant difference in tumor recurrence(7.7%vs.2.9%)and metastasis(3.8%vs.2.9%)between the two groups(P>0.05).However,the incidence of impaired internal and external pancreatic function in the preservation group was significantly lower than that in the traditional group(5.8%vs.23.1%,P=0.035).Conclusion Restricted pancreatectomy,which preserves pancreatic function,is safe and feasible in benign and borderline tumors.It preserves more normal pancreatic tissue to the maximum extent,reduces the impairment of internal and exocrine functions of the pancreas,and improves the postoperative quality of life of patients.