摘要
目的:探讨"一针法"胰肠吻合方式在腹腔镜胰十二指肠切除术(LPD)中的初期应用效果.方法:回顾分析2019 年1 月至2019 年12 月应用洪德飞教授创作的"一针法"进行胰肠吻合的34 例LPD患者的临床资料.结果:34 例患者均顺利完成LPD,手术时间305.0(280.0,327.5)min,胰肠吻合时间41.5(38.0,45.0)min,术中出血量210.0(172.5,243.8)mL,术后住院13.5(10.3,15.8)d.术后胰瘘发生率14.7%(5/34),其中B级胰瘘4 例,C级胰瘘1 例;胆漏发生率5.9%(2/34);胃排空延迟发生率 11.8%(4/34),其中A级 3 例,B级 1 例,未出现C级;出血发生率为 8.8%(3/34),腹腔感染率 2.9%(1/34),切口感染率5.9%(2/34),二次手术率2.9%(1/34);围手术期无死亡病例.结论:"一针法"应用于LPD开展初期是安全、可靠的,可有效降低手术难度,对于LPD初学者平稳度过学习曲线具有一定帮助,值得初学者学习与推广.
Abstract
Objective:To investigate the initial application effect of"one stitch method"in the laparoscopic pancreatoduode-nectomy(LPD).Methods:Clinical data of 34 LPD patients who underwent pancreaticoenterostomy with the"one stitch method"crea-ted by professor Hong Defei were retrospectively analyzed from Jan.2019 to Dec.2019.Results:LPD was successfully performed in 34 patients.The operation time was 305.0(280.0,327.5)min,the pancreaticojejunostomy time was 41.5(38.0,45.0)min,the intraopera-tive blood loss was 210.0(172.5,243.8)mL,and the postoperative hospital stay was 13.5(10.3,15.8)d.The incidence of postopera-tive pancreatic fistula was 14.7%(5/34),including 4 cases of grade B pancreatic fistula and 1 case of grade C pancreatic fistula.The incidence of biliary leakage was 5.9%(2/34).The incidence of delayed gastric emptying was 11.8%(4/34),including 3 cases of grade A,1 case of grade B and 0 case of grade C.The incidence of bleeding was 8.8%(3/34).The incidence of abdominal infection was 2.9%(1/34).The incidence of incision infection was 5.9%(2/34).Reoperation was performed in 2.9%patients(1/34).There was no perioperative death.Conclusions:The application of"one stitch method"in the early stage of LPD is safe and reliable,can effectively reduce the difficulty of surgery,and has certain help for LPD beginners to smoothly overcome the early learning curve,which is worthy of learning and promotion for LPD beginners in clinical work.
基金项目
安徽省卫生健康委科研项目(AHWJ2022b032)
安徽省教育厅重点项目(2022AH052337)
蚌埠医学院研究生科研创新计划立项项目(Byycx23120)
国家科技期刊平台
NSTL
万方数据