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首页> 外文期刊>Surgical Endoscopy >Laparoscopic gastro- and hepaticojejunostomy for palliation of pancreatic cancer: a case controlled study.
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Laparoscopic gastro- and hepaticojejunostomy for palliation of pancreatic cancer: a case controlled study.

机译：腹腔镜胃和肝空肠吻合术治疗胰腺癌：病例对照研究。

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BACKGROUND: Most patients presenting with pancreatic cancer are irresectable at the time the diagnosis is made. Therefore, they are in need of palliative treatment that can guarantee minimal morbidity, mortality, and hospital stay. To address this need, we designed a study to test the feasibility of laparoscopic gastroenterostomy and hepaticojejunostomy and to compare their results with those achieved with open techniques. METHODS: We performed a case control study of a new concept in laparoscopic palliation based on the findings of preoperative imaging and diagnostic laparoscopy. Laparoscopic side-to-side gastroenterostomy and end-to-side hepaticojejunostomy (Roux-en-Y) were done in irresectable cases. Of 14 patients who underwent laparoscopic palliation, three had a laparoscopic double bypass, seven had a gastroenterostomy, and four underwent staging laparoscopy only. The results were compared with a population of 14 matched patients who had conventional palliative procedures. RESULTS: Postoperative morbidity was 7% vs 43% for laparoscopic and open palliation, respectively (p < 0.05). There were no mortalities in the laparoscopic group, as compared to 29% in the group who had open bypass surgery (p < 0.05). Postoperative hospital stay averaged 9 days in the laparoscopic group and 21 days in the open group (p < 0.06). Operating time tended to be shorter in the laparoscopic group (p < 0.25). Morphine derivatives were necessary for a significantly shorter period after laparoscopic surgery (p < 0.03). CONCLUSIONS: Our preliminary experience strongly suggests that laparoscopic palliation can reduce the three major drawbacks of open bypass surgery-i.e., high morbidity, high mortality, and long hospital stay.
机译：背景：大多数患有胰腺癌的患者在做出诊断时无法切除。因此，他们需要姑息治疗，以保证最低的发病率，死亡率和住院时间。为了满足这一需求，我们设计了一项研究，以测试腹腔镜胃肠肠吻合术和肝空肠吻合术的可行性，并将其结果与开放技术的结果进行比较。方法：我们根据术前影像学和诊断性腹腔镜检查的结果，对腹腔镜缓解术的新概念进行了病例对照研究。在无法切除的病例中，进行了腹腔镜侧胃肠吻合术和端侧肝空肠吻合术（Roux-en-Y）。在接受腹腔镜缓解术的14位患者中，三位接受了腹腔镜双旁路手术，七位接受了肠胃造口术，四位仅接受了腹腔镜分期。将结果与14例采用常规姑息治疗的匹配患者进行了比较。结果：腹腔镜和开放性姑息术的术后发病率分别为7％和43％（p <0.05）。腹腔镜手术组没有死亡率，而进行开放式旁路手术的组只有29％（p <0.05）。腹腔镜组术后平均住院天数为9天，开放组平均为21天（p <0.06）。腹腔镜手术组的手术时间往往较短（p <0.25）。吗啡衍生物对于腹腔镜手术后明显较短的时间是必需的（p <0.03）。结论：我们的初步经验强烈表明，腹腔镜手术减轻可减少开放旁路手术的三个主要弊端，即高发病率，高死亡率和长期住院。

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