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目的评估腹腔镜胰岛素瘤切除术的可行性和安全性。方法2002年6月至2004年6月25例胰岛素瘤患者,分别行腹腔镜胰岛素瘤切除术(腹腔镜组,10例)和开腹胰岛素瘤切除术(开腹手术组,15例),比较2组手术时间、术中出血量、术后住院天数和并发症发生率差异是否有统计学意义。结果肿瘤发生部位、大小差异无统计学意义,手术时间、术中出血量和术后平均住院天数等差异均无统计学意义(P>0.05)。并发症发生率方面,腹腔镜手术组仅1例并发胰瘘,开腹手术组3例并发胰瘘、2例并发腹腔感染、5例并发胸腔积液,开腹手术组并发症发生率显著高于腹腔镜手术组(P<0.01)。结论位于胰体或尾部的胰岛素瘤行腹腔镜下胰岛素瘤切除术是安全可行的,并且并发症发生率低于经典的开腹手术。
Objective To evaluate the feasibility and safety of laparoscopic insulinoma resection. Methods Twenty-five patients with insulinoma from June 2002 to June 2004 were treated with laparoscopic insulinoma (laparoscopic group, 10 cases) and open excision of insulinoma (open surgery group, 15 cases) There was no significant difference between the two groups in operation time, blood loss, postoperative hospital stay and complication rate. Results There was no significant difference in tumor location and size between the two groups (P> 0.05). There was no significant difference in the operation time, intraoperative blood loss and average postoperative hospital stay. Complications incidence, laparoscopic surgery group, only 1 case complicated with pancreatic fistula, laparotomy group 3 cases complicated by pancreatic fistula, 2 cases complicated by abdominal infection, 5 cases of concurrent pleural effusion, open surgery group complication rate was significantly higher In laparoscopic surgery group (P <0.01). Conclusion Laparoscopic insulinoma resection of insulinoma located in the body or tail of the pancreas is safe and feasible, and the complication rate is lower than that of the classic laparotomy.