胰腺全系膜切除用于腹腔镜胰头癌根治术34例疗效分析

发布时间：2018-11-28 08:15

【摘要】：目的探讨胰腺全系膜切除(TMp E)用于腹腔镜胰头癌根治术的可行性及有效性。方法回顾性分析2014年11月至2017年1月河北医科大学第二医院肝胆外科行腹腔镜胰十二指肠切除术34例胰头癌病人的临床资料,均应用动脉先行技术实施TMp E。随访观察并发症发生情况及术后存活情况。结果 34例病人均实施全腹腔镜手术,手术时间为(468.7±78.2)min,术中出血(748.5±256.5)m L。术后13例发生并发症,其中5例发生胰瘘,无围手术期死亡病例。清扫淋巴结数目为7~25(14.6±3.8)枚,其中23例存在淋巴结转移,其数目为1~8(2.7±1.1)枚。34例中28例(82.4%)达到R0切除。截至2017-01-30,随访8(1~25)个月,7例病人死亡,其中1例术后2个月因肺部感染死亡,另6例均因肿瘤复发死亡,术后生存期为11(5~14)个月,余27例存活病人仍在随访中。结论 TMp E用于腹腔镜胰头癌根治术安全可行,有助于提高R0切除率。
[Abstract]:Objective to evaluate the feasibility and efficacy of total mesenterectomy (TMp E) in laparoscopic radical resection of pancreatic head carcinoma. Methods the clinical data of 34 patients with pancreatic head carcinoma underwent laparoscopic pancreaticoduodenectomy in the second Hospital of Hebei Medical University from November 2014 to January 2017 were retrospectively analyzed. All patients were treated with arterial technique to perform TMp. Complications and postoperative survival were observed. Results Total laparoscopic surgery was performed in all 34 patients, and the operative time was (468.7 卤78.2) min, bleeding (748.5 卤256.5) m L.). Postoperative complications occurred in 13 cases, including pancreatic fistula in 5 cases and no perioperative death. The number of lymph nodes dissected was 70.25 (14.6 卤3.8), of which 23 had lymph node metastasis, and the number of lymph nodes was 1p8 (2.7 卤1.1). In 34 cases, 28 cases (82.4%) had R0 resection. As of January 30, 2017-01-30, 7 patients died after follow up for 8 (1 / 25) months, 1 case died of pulmonary infection 2 months after operation, and 6 cases died of tumor recurrence. The postoperative survival time was 11 (5 / 14) months. The remaining 27 patients were still being followed up. Conclusion it is safe and feasible to use TMp E in laparoscopic radical resection of pancreatic head cancer, and it is helpful to improve the rate of R 0 resection.
【作者单位】：河北医科大学第二医院;
【基金】：河北省教育厅科学研究计划(No.2006137)
【分类号】：R735.9

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