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目的:探讨腹腔镜胰十二指肠切除术治疗胆总管下段癌的安全性与可行性。方法:就我科于2005年1月用腹腔镜进行的一例胆总管下段癌所作胰十二指肠切除术,研究其手术技术、手术安全性、术后恢复情况和随访结果。结果:手术顺利,无术中严重并发症;手术时间6.5h,术中出血约50ml。术后恢复良好,术后第3天胃肠道功能恢复,第4天下床,第6天开始进流质。术后有少量胰漏,经单纯吸引后痊愈;无胃肠、胆肠吻合口漏等严重并发症;术后30d出院。出院后1个月,随访情况良好。结论:具丰富腔镜手术经验的专业医师施行腹腔镜胰十二指肠切除术具有可行性与安全性。本例的长期疗效有待进一步随访观察。本手术方法有待更多经验积累及随机临床论证。
Objective: To investigate the safety and feasibility of laparoscopic pancreatoduodenectomy in the treatment of lower common bile duct cancer. Methods: In our department in January 2005 laparoscopic cholecystectomy for pancreaticoduodenectomy to study its surgical techniques, surgical safety, postoperative recovery and follow-up results. Results: The operation was smooth with no serious intraoperative complications. The operation time was 6.5 hours and the intraoperative bleeding was about 50ml. Postoperative recovery was good, the function of gastrointestinal tract was recovered on the third day after operation, and the bed went to bed on the fourth day and began to enter the liquid phase on the sixth day. A small amount of pancreatic leakage after surgery, recovered by a simple suction; no gastrointestinal, cholecystoera anastomotic leakage and other serious complications; 30d postoperative discharge. One month after discharge, the follow-up was good. CONCLUSIONS: Laparoscopic pancreatoduodenectomy is a feasible and safe procedure for professional physicians with experience of endoscopic surgery. The long-term efficacy of this case needs further follow-up observation. The surgical method needs more experience and randomized clinical demonstration.