摘要
目的:探讨近端胰岛素瘤切除术的技术要点、可行性及安全性。方法:回顾分析2003年3月至2010年2月行腹腔镜手术治疗38例胰岛素瘤患者的临床资料,按肿瘤位置分为近端组和远端组,探讨两组的技术要点,分析两组的手术方式、手术时间、出血量及并发症发生率。结果:2例未找到病灶终止手术,36例顺利完成手术,其中近端组16例,远端组21例(1例为颈、体多发肿瘤同时计入两组)。近端组均行肿瘤切除术,远端组包括肿瘤切除术6例,胰体尾切除术15例(其中保脾7例)。近端组与远端组相比,手术中转率(18.8%vs.14.3%)、并发症发生率(56.3%vs.28.6%)、手术时间[(205±66.7)minvs.(202±90.0)min]差异无统计学意义(P>0.05),出血量较少[(68.7±49.4)ml vs.(118.0±98.3)ml,P<0.05)],术后住院时间明显延长[(14.4±8.2)d vs.(7.6±1.7)d,P<0.05)]。结论:近端胰岛细胞瘤的腹腔镜切除总体是安全可行的,但与远端胰腺胰岛素瘤相比技术难度较大,需要谨慎选择合适的病例。
Objective：To discuss the key points of laparoscopic resection for the proximal pancreatic insulinoma and to assess the feasibility and safety of this procedure.Methods：The medical data of 38 cases insulinoma treated by laparoscopic resection from Mar.2003 to Feb.2010 was collected and retrospectively reviewed.All the cases were divided into the proximal group and the distal group according to the tumor location.The key points of 2 groups were investigated,and the surgical procedure,operative time,intraoperative blood loss and the complications were compared.Results：We failed to localize the tumor in 2 cases and succeeded in the other 36 cases,including 16 cases in proximal group and 21 cases in distal group（1 case with multiple tumor both in the neck and body was repeatedly counted in both groups）.The procedure included 16 tumor enucleations in the proximal group and 6 enucleations and 15 distal pancreatectomies（including 7 cases of sparing splenectomy） in the distal group.The proximal group had similar conversion rate（18.8% vs.14.3%）,complications rate（56.3% vs.28.6%） and operative time[（205±66.7）min vs.（202±90.0）min] with the distal group（P0.05）.And the intraoperative blood loss[（68.7±49.4）ml vs.（118.0±98.3）ml] was less and the postoperative hospital stay[（14.4±8.2）d vs.（7.6±1.7）d] was longer compared to the distal group（P0.05）.Conclusions：Although laparoscopic resection for proximal pancreatic insulinoma is more difficult than that of distal pancreatic insulinoma,it is generally safe and feasible for experienced surgeons and selected cases.
出处
《腹腔镜外科杂志》
2010年第5期338-340,共3页
Journal of Laparoscopic Surgery
