背景:在这项研究中,我们旨在探讨腹腔镜保留十二指肠胰头切除术(LDPPHR)治疗胰头囊性肿瘤的短期临床结局.
方法:本回顾性研究纳入山东第一医科大学附属山东省立医院2019年12月至2022年7月收治的胰头囊性肿瘤患者60例。
结果:两组患者的基线和病理特征无明显差异(P>0.05)。与腹腔镜胰十二指肠切除术(LPD)组相比,LDPPHR组的术后排气时间更短(2(2和4)vs.4(3和5)天;P=0.003)。两组手术时间差异无统计学意义,估计失血量,术中输血,术后第一天的血红蛋白水平,出院前总胆红素,出院前直接胆红素,术后住院时间,术后胰瘘,胆漏,出血,腹腔积液,腹部感染,胃排空延迟,介入栓塞止血,再操作,再入院30天(P>0.05)。两组均未发现转化和90天死亡率。LDPPHR组术后3个月PNI较高,术后6个月TG和术后6个月BMI高于LPD组(P<0.05)。
结论:与LPD相比,LDPPHR可减少患者术后排气时间,改善术后短期营养状况,且不降低围手术期的安全性。
BACKGROUND: In this study, we aimed to investigate the short-term clinical outcomes of laparoscopic duodenum-preserving pancreatic-head resection (LDPPHR) for the management of pancreatic-head cystic neoplasms.
METHODS: This retrospective study included 60 patients who were treated with pancreatic-head cystic neoplasms at the Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2019 to July 2022.
RESULTS: No significant difference was found between the two groups in terms of the baseline and pathological characteristics of patients (P > 0.05). The postoperative exhaust time was shorter in the LDPPHR group compared with the laparoscopic pancreaticoduodenectomy (LPD) group (2 (2 and 4) vs. 4 (3 and 5) days; P = 0.003). No significant difference was found between the two groups in terms of operative time, estimated blood loss, intraoperative transfusion, hemoglobin levels on the first postoperative day, total bilirubin before discharge, direct bilirubin before discharge, postoperative hospital stay, postoperative pancreatic fistula, bile leakage, hemorrhage, peritoneal effusion, abdominal infection, delayed gastric emptying, interventional embolization hemostasis, reoperation, and 30-day readmission (P > 0.05). No conversion and 90-day mortality were found in the two groups. The LDPPHR group showed a higher 3-month postoperative PNI, 6-month postoperative TG and 6-month postoperative BMI than the LPD group (P < 0.05).
CONCLUSIONS: Compared with LPD, LDPPHR can decrease the postoperative exhaust time of patients, improve the short-term postoperative nutritional status, and does not decrease the safety of the perioperative period.