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赵之明, 姜楠, 高元兴, 等. 达芬奇机器人手术切除胰腺浆液性囊腺瘤148例分析[J]. 四川大学学报(医学版), 2020, 51(4): 467-471. DOI: 10.12182/20200760201
引用本文: 赵之明, 姜楠, 高元兴, 等. 达芬奇机器人手术切除胰腺浆液性囊腺瘤148例分析[J]. 四川大学学报(医学版), 2020, 51(4): 467-471. DOI: 10.12182/20200760201
ZHAO Zhi-ming, JIANG Nan, GAO Yuan-xing, et al. Robotic Surgery for Pancreatic Serous Cystadenoma: Analysis of 148 Cases[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(4): 467-471. DOI: 10.12182/20200760201
Citation: ZHAO Zhi-ming, JIANG Nan, GAO Yuan-xing, et al. Robotic Surgery for Pancreatic Serous Cystadenoma: Analysis of 148 Cases[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(4): 467-471. DOI: 10.12182/20200760201

达芬奇机器人手术切除胰腺浆液性囊腺瘤148例分析

Robotic Surgery for Pancreatic Serous Cystadenoma: Analysis of 148 Cases

  • 摘要:
      目的  探讨机器人手术治疗胰腺浆液性囊腺瘤的临床疗效。
      方法  回顾性分析2015年4月−2019年6月我科采用机器人手术系统治疗的胰腺浆液性囊腺瘤148例患者的术中资料、围手术期并发症及病理资料等临床数据。
      结果  肿瘤位于胰头部39例(26.4%),胰腺颈部15例(10.1%),胰体尾部94例(63.5%)。行胰十二指肠切除26例(17.6%)、远端胰腺切除71例(48.0%)、胰腺中段切除24例(16.2%)、肿瘤局部切除27例(18.2%),术后严重并发症率分别为7.7%、2.8%、0、0,B级胰瘘率分别为7.7%、7.0%、41.7%、14.8%,无C级胰瘘,90 d死亡率为0。对比胰十二指肠切除,胰头肿瘤局部切除术的手术时间更短(P<0.001)、术中出血更少(P<0.001),术后住院时间更短(P<0.001)。对比胰腺中段切除+胰肠吻合术,“荣式”胰腺中段切除术的手术时间(P=0.007)和术后住院时间更短(P=0.040)。
      结论  达芬奇机器人手术系统治疗胰腺浆液性囊腺瘤安全可行。对于胰头部浆液性囊腺瘤,建议首选在术中超声引导下的局部切除,对于胰腺中段浆液性囊腺瘤,可选择机器人“荣式”胰腺中段切术。

     

    Abstract:
      Objective  To investigate the clinical efficacy of robotic surgery for pancreatic serous cystadenoma.
      Methods  There were 148 patients with pancreatic serous cystadenoma underwent robotic surgery from April 2015 to June 2019 in our department, the clinical data including intraoperative data, perioperative complications, and histopathological results were retrospectively analyzed.
      Results  Among the 148 patients, there were 39 cases (26.4%) of the tumors located in pancreatic head, 15 cases (10.1%) in pancreatic neck and 94 cases (63.5%) in pancreatic body and tail. Pancreaticoduodenectomy, distal pancreatectomy, central pancreatectomy, and enucleation were performed in 26 cases (17.6%), 71 cases (48.0%), 24 cases (16.2%) and 27 (18.2%) cases, respectively. The incidence of serious postoperative complications were 7.7%, 2.8%, 0, 0, respectively, and grade B pancreatic fistula were 7.7%, 7.0%, 41.7%, 14.8%, respectively. 90-day mortality was 0. Compared with pancreaticoduodenectomy, enucleation of the pancreatic head tumor had shorter operation time (P<0.001), less intraoperative blood loss (P<0.001), and shorter length of hospital stay (P<0.001). Compared with central pancreatectomy+pancreaticojejunostomy, Rong central pancreatectomy had shorter operation time (P=0.007) and length of hospital stay (P=0.040).
      Conclusion  Robotic surgery for pancreatic serous cystadenomaisis safe and feasible. Rong central pancreatectomy for serous cystadenoma in middle segmental pancreas could achieve feasible results.

     

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