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目的探讨腹腔镜胰腺中段切除手术在胰腺颈体部疾病的临床效果及应用价值。方法回顾性分析2012年3月—2014年3月郑州大学第四附属医院接受胰腺中段切除手术的60例患者临床资料,评价临床疗效及预后效果。结果 60例患者手术均获成功,围手术期均未出现死亡。术后出现5例胰瘘(8.3%),其中胰体空肠Roux-en-Y吻合3例(8.1%),胰体、胰头空肠Roux-en-Y双吻合2例(8.7%);腹腔内出血2例(3.3%)。术后病理诊断囊腺瘤23例,内分泌肿瘤14例。其中2例死于胰腺癌扩散,其余患者均存活。结论对于胰颈部或体部良性及低度恶性肿瘤而言,胰腺中段切除术能最大限度保留正常胰腺组织,维持腺体内内外分泌功能,促进消化吸收。不过该术式需严格掌握手术指证,以减少不良反应,提高预后。
Objective To investigate the clinical effect and application value of laparoscopic mid-surgical pancreatic resection in the pancreatic and neck diseases. Methods The clinical data of 60 patients undergoing pancreatic mid-segmentectomy from March 2012 to March 2014 in the Fourth Affiliated Hospital of Zhengzhou University were retrospectively analyzed to evaluate the clinical efficacy and prognosis. Results All the 60 patients were successfully operated and no death occurred during the perioperative period. There were 5 cases of pancreatic fistula (8.3%) after operation. Roux-en-Y pancreatic jejunum was anastomosed in 3 cases (8.1%). Pancreatic body and pancreatic head jejunum Roux-en-Y double anastomosis in 2 cases (8.7%); abdominal cavity Internal bleeding in 2 cases (3.3%). Postoperative pathological diagnosis of cystadenoma in 23 cases, 14 cases of endocrine tumors. Two of them died of pancreatic cancer spread, and the remaining patients survived. Conclusions For pancreatic neck or benign and low-grade tumors, the middle pancreatic resection can maximize the retention of normal pancreatic tissue, maintain the internal and external secretion of the gland, and promote digestion and absorption. However, this procedure requires strict control of surgical indications to reduce adverse reactions and improve prognosis.