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首页> 外文期刊>Surgical Endoscopy >Laparoscopic pancreatic surgery: current indications and surgical results.
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Laparoscopic pancreatic surgery: current indications and surgical results.

机译：腹腔镜胰腺手术：目前的适应症和手术结果。

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BACKGROUND: Although minimally invasive surgery has achieved worldwide acceptance in various fields, laparoscopic surgery for pancreatic diseases has been reported only rarely. The purpose of this study was to evaluate the outcomes and feasibility of laparoscopic pancreatic surgery. METHODS: Fifteen patients, comprising eight men and seven women with an average age of 54 years, underwent laparoscopic pancreatic surgery. Distal pancreatectomy was indicated for solid tumors ( n = 4), cystic lesions ( n = 3), and chronic pancreatitis ( n = 2). Cystogastrostomy was performed for pseudocysts ( n = 4) and enucleation for insulinomas ( n = 2). The lesions varied in size from 1 to 9 cm (2.9 +/- 2.4 cm) and were located in the pancreatic head ( n = 2), body ( n = 3), or tail ( n = 10). For distal pancreatectomy, the splenic artery was divided and the parenchyma was transected with a linear stapler. Laparoscopic ultrasonography was used to determine the distance between the tumor and the main pancreatic duct forenucleation as well as to localize the lesion for distal pancreatectomy. Cystogastrostomy, 4.5 cm in length, was also performed with the linear stapler through the window of the lesser omentum. RESULTS: Mean operation time was 249 +/- 70 min (293 +/- 58 min in distal pancreatectomy, 185 +/- 14 min in enucleation, 204 +/- 50 min in cystogastrostomy), and mean blood loss was 138 +/- 184 g (213 +/- 227 g, 75 +/- 35 g, 38 +/- 48 g, respectively). Two distal pancreatectomies (13%) were converted to open surgery due to severe peripancreatic inflammation. There was no related mortality, but there were two cases (15%) of pancreatic fistula, one in a distal pancreatectomy case and the other in an enucleation case, and both were treated conservatively. CONCLUSIONS: Laparoscopic pancreatic surgery is safe and feasible for patients with benign tumors and cystic lesions.
机译：背景：尽管微创手术已在各个领域获得世界范围的接受，但腹腔镜手术治疗胰腺疾病的报道很少。这项研究的目的是评估腹腔镜胰腺手术的结果和可行性。方法：15例患者，包括8名男性和7名女性，平均年龄为54岁，接受了腹腔镜胰腺手术。远端胰腺切除术适用于实体瘤（n = 4），囊性病变（n = 3）和慢性胰腺炎（n = 2）。对假性囊肿进行了胃胃造口术（n = 4），对胰岛素瘤进行了摘除术（n = 2）。病变的大小从1到9厘米（2.9 +/- 2.4厘米）不等，位于胰头（n = 2），身体（n = 3）或尾巴（n = 10）中。对于远端胰腺切除术，将脾动脉分开，并用线性吻合器切开实质。腹腔镜超声检查可用于确定肿瘤与胰腺主胰管摘除术之间的距离以及对远端胰腺切除术的病变部位进行定位。长度为4.5厘米的膀胱胃造口术也通过线性缝合器穿过小网膜的窗口进行。结果：平均手术时间为249 +/- 70分钟（远端胰腺切除术为293 +/- 58分钟，摘除术为185 +/- 14分钟，膀胱造口术为204 +/- 50分钟），平均失血量为138 + / -184克（分别为213 +/- 227克，75 +/- 35克，38 +/- 48克）。由于严重的胰腺周围炎症，两次远端胰腺切除术（13％）被转为开放手术。没有相关的死亡率，但有2例（15％）胰瘘，其中1例在远端胰切除术病例中，另一例在摘除病例中，均接受了保守治疗。结论：腹腔镜胰腺手术对于良性肿瘤和囊性病变患者是安全可行的。

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