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目的 探讨“逆时针切除法”在完全腹腔镜胰十二指肠切除术中的应用并总结其体会.方法 回顾性分析2016年7月至2017年1月期间中国医科大学附属盛京医院胰腺中心收治的8例行完全腹腔镜胰十二指肠切除术患者的临床资料.结果 8例患者中男3例,女5例;年龄(64.13±15.01)岁.十二指肠癌1例,胆管中下段癌2例,胰头癌4例,胰头巨大实性假乳头状瘤1例.本组8例患者均顺利完成手术,手术时间为(527.50±69.44) min,术中出血量为(368.75±162.43)mL,标本切除时间为(241.25±38.71)min,术后住院时间为(18.67±4.00)d.根据国际胰腺外科研究小组标准,术后发生A级胰瘘3例,B级胰瘘1例;所有患者无围手术期死亡、无术后出血及无胃排空障碍发生,仅有1例患者出现腹腔感染,胰瘘和腹腔感染患者均经保守治疗治愈.所有患者处于正常随访中,现无任何异常情况.结论 从本组有限的病例资料初步来看,“逆时针切除法”可能是在完全腹腔镜下一种简便、安全、有效且比较容易掌握的切除法,但这还需要更多的临床实践来验证.“,”Objective To discuss application of“counter clockwise resection” in total laparoscopic pancreaticoduodenectomy (TLPD) and summarize it's preliminary experiences.Method The clinical data of consecutive 8 patients underwent TLPD in the Department of Pancreatic Surgery,Affiliated Shengjing Hospital of China Medical University from July 2016 to January 2017 were analyzed retrospectively.Results There were 3 males and 5 females in these 8 patients.The age was (64.13±15.0 1) years.The results of postoperative pathology included 1 duodenal cancer,2 distal biliary tract cancers,4 pancreatic head cancers,and 1 solid pseudopapillary tumor of pancreatic head.All the 8 patients were performed with TLPD successfully,and the time of the operation was (527.50±69.44) min,the resection time of the specimen was (241.25±38.71) min,and the blood loss was (368.75±162.43) mL,the postoperative hospitalization stay was (18.67±4.00) d.There were no postoperative bleeding,perioperative death,and delayed gastric emptying.Four patients suffered from the pancreatic fistula including 3 cases of grade A and 1 case of grade B pancreatic fistulas,and 1 case suffered from the intra-abdominal infection,who were cured after the conservative treatment.All the patients were following-up,and there was no abnormality.Conclusion Preliminary results of limited cases in this study show that “counter clockwise resection” might be a safe,effective,and easy method of TLPD,but further research is need to study.