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目的探讨机器人手术系统行胰腺钩突肿瘤切除术的临床疗效。方法回顾性分析自2010年12月至2013年12月上海交通大学医学院附属瑞金医院完成的6例机器人手术系统辅助胰腺钩突肿瘤切除术的临床资料。结果 6例手术均顺利完成,无中转开腹。病人平均年龄51.7(40~64)岁,男性3例,女性3例。平均手术时间143.3(100~200)min;平均术中出血80(30~150)m L;平均术后住院天数23.8(13~44)d;术后2例出现B级胰瘘,1例出现C级胰瘘及肺部感染;无死亡病例。术后病理检查报告:4例为导管内乳头状黏液性肿瘤(IPMT),1例为胰岛素瘤,1例为实性假乳头状瘤(SPT)。术后常规随访:根据手术时间分别随访2个月至2年,术后均未因相关并发症再次入院,均未发现肿瘤复发。结论机器人手术系统辅助胰腺钩突肿瘤切除术安全可行,成功率高,较传统开腹手术及腹腔镜手术,具有一定优势,但术后出现胰瘘等并发症概率仍较高。
Objective To investigate the clinical efficacy of robotic surgery in patients with pancreaticobulbar tumor resection. Methods A retrospective analysis was performed on the clinical data of 6 cases of robotic surgical system assisted pancreas uncinate tumor resection completed by Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from December 2010 to December 2013. Results 6 cases of surgery were successfully completed, no transit laparotomy. The average age of patients 51.7 (40 ~ 64) years old, 3 males and 3 females. The average operation time was 143.3 (100-200) minutes. The mean intraoperative bleeding was 80 (30-150) m L. The average postoperative hospital stay was 23.8 (13-44) days. Grade B pancreatic fistula was found in 2 cases and in 1 case Class C pancreatic fistula and lung infection; no deaths. Postoperative pathological examination report: 4 cases of intraductal papillary mucinous neoplasm (IPMT), 1 case of insulinoma, and 1 case of solid pseudopapillary tumor (SPT). Postoperative routine follow-up: According to the operation time were followed up for 2 months to 2 years, were not hospitalized for complications associated with recurrent, were not found tumor recurrence. Conclusions Robotic surgical assisted resection of pancreaticobulbar tumor is safe and feasible with high success rate. It has some advantages over traditional laparotomy and laparoscopic surgery, but there is still a high probability of complications such as pancreatic fistula after operation.