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腹腔镜下远端胰腺切除术治疗良性或交界性恶性胰腺肿瘤。

Laparoscopic distal pancreatectomy for benign or borderline malignant pancreatic tumors.

作者信息

Chung Jun Chul, Kim Hyung Chul, Song Ok Pyung

机构信息

Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.

出版信息

Turk J Gastroenterol. 2014 Dec;25 Suppl 1:162-6. doi: 10.5152/tjg.2014.4389.

Abstract

BACKGROUND/AIMS: Laparoscopic distal pancreatectomy (LDP) for benign conditions is increasingly performed. But, there are few limited studies about the outcomes of the laparoscopic surgery compared with open surgery. The aim of this study was to evaluate the clinical outcomes of LDP and compare it to that of open distal pancreatectomy (ODP).

MATERIALS AND METHODS

From July 2007 to February 2012, 60 consecutive patients (41 LDP patients and 19 ODP patients) who underwent elective distal pancreatectomy with an apparent diagnosis of benign or borderline malignant tumor were recruited into the current study.

RESULTS

There were no significant differences in operation time, transfusion, intravenous patient-controlled analgesia (IV-PCA) duration, pancreatic fistula, mortality, and recurrence between the two groups. Compared to ODP, LDP had lower blood loss (272.7±134.8 vs. 476.9±140.8 ml; p=0.002), shorter time to first flatus (2.4±0.5 vs. 4.0±1.5 days; p=0.003), earlier time to oral intake (3.4±1.6 vs. 5.4±1.9 days; p=0.013), and shorter postoperative hospital stay (9.4±6.9 vs. 17.0±6.7 days; p=0.043).

CONCLUSION

LDP is a safe procedure and should be considered as a standard treatment option for benign or borderline malignant pancreatic tumors.

摘要

背景/目的:腹腔镜远端胰腺切除术(LDP)用于良性疾病的情况越来越多。但是,与开放手术相比,关于腹腔镜手术结果的有限研究较少。本研究的目的是评估LDP的临床结果,并将其与开放远端胰腺切除术(ODP)的结果进行比较。

材料与方法

从2007年7月至2012年2月,连续60例接受择期远端胰腺切除术且明显诊断为良性或交界性恶性肿瘤的患者(41例LDP患者和19例ODP患者)被纳入本研究。

结果

两组在手术时间、输血、静脉自控镇痛(IV-PCA)持续时间、胰瘘、死亡率和复发率方面无显著差异。与ODP相比,LDP的失血量更低(272.7±134.8 vs. 476.9±140.8 ml;p=0.002),首次排气时间更短(2.4±0.5 vs. 4.0±1.5天;p=0.003),开始经口进食时间更早(3.4±1.6 vs. 5.4±1.9天;p=0.013),术后住院时间更短(9.4±6.9 vs. 17.0±6.7天;p=0.043)。

结论

LDP是一种安全的手术方法,应被视为良性或交界性恶性胰腺肿瘤的标准治疗选择。

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