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首页> 外文期刊>Surgical Endoscopy >Laparoscopic versus open approach for solitary insulinoma.
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Laparoscopic versus open approach for solitary insulinoma.

机译：腹腔镜与开放式手术治疗孤立性胰岛素瘤的比较。

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BACKGROUND: In recent years, advances in laparoscopic techniques have allowed surgeons to treat pancreatic lesions laparoscopically. Insulinoma, the most prevalent pancreatic endocrine tumor, is mostly benign and curable with surgical resection. This study aimed to assess the results from laparoscopic resection (LG) of insulinomas and to compare them with the results from open surgery (OG). METHODS: From September 1999 to December 2005, 56 laparoscopic pancreatic resections were performed for selected patients, including 12 laparoscopic resections of insulinomas. The results were compared with those of patients who underwent open resection of insulinomas selected from the authors' pancreatic database. RESULTS: Three conversions to the open approach were required because of inability to identify the tumor. There were no deaths in either group, and the morbidity rates were 25% (3/12) for LG and 55% (5/9) for OG (nonsignificant difference). The pancreatic fistula rate after laparoscopic enucleation was statistically lower than after open enucleation (14% vs 100%; p = 0.015). The mean postoperative hospital stay was 13 +/- 5.9 days for LG and 17.6 +/- 7.5 days for OG (nonsignificant difference). After exclusion of the patients who underwent conversion to laparotomy, the mean postoperative hospital stay was 11.5 +/- 5.8 days for LG and 17.6 +/- 7.5 days for OG (p = 0.04). CONCLUSION: This study demonstrates the feasibility and safety of laparoscopic resection of insulinomas. The laparoscopic approach was associated with a decrease in hospital stay and pancreatic fistula after enucleation. Preoperative localization tests and laparoscopic ultrasonography seem necessary to prevent conversion.
机译：背景：近年来，腹腔镜技术的进步使外科医生可以腹腔镜治疗胰腺病变。胰岛素瘤是最普遍的胰腺内分泌肿瘤，大部分是良性的，可通过手术切除治愈。这项研究旨在评估胰岛素瘤的腹腔镜切除术（LG）的结果，并将其与开放手术（OG）的结果进行比较。方法：1999年9月至2005年12月，对部分患者行腹腔镜胰切除术56例，其中胰岛素瘤的腹腔镜切除术12例。将结果与从作者的胰腺数据库中选择的接受胰岛素瘤开放切除术的患者进行了比较。结果：由于无法识别肿瘤，需要三次转换为开放治疗。两组均无死亡，LG的发病率为25％（3/12），OG的发病率为55％（5/9）（无显着性差异）。腹腔镜摘除后的胰瘘发生率明显低于开放摘除后的胰瘘发生率（14％vs 100％; p = 0.015）。 LG的平均术后住院时间为13 +/- 5.9天，OG的平均住院时间为17.6 +/- 7.5天（无显着性差异）。排除接受开腹手术的患者后，LG的平均术后住院时间为11.5 +/- 5.8天，OG的平均术后住院时间为17.6 +/- 7.5天（p = 0.04）。结论：本研究证明了腹腔镜切除胰岛素瘤的可行性和安全性。摘除后，腹腔镜手术与住院时间和胰瘘减少有关。术前定位测试和腹腔镜超声检查似乎是必要的，以防止转换。

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