论文部分内容阅读
目的评估腹腔镜胰岛素瘤切除术的安全性以及比较腹腔镜和开腹胰岛素瘤切除术的临床特点。方法采用回顾性收集分析临床资料,2004年7月至2013年11月共51例胰岛素瘤患者,分别行腹腔镜胰岛素瘤切除术(腹腔镜组,14例)和开腹胰岛素瘤切除术(开腹组,37例),比较两组手术时间、术中出血量、术后住院天数及并发症。结果比较腹腔镜组和开腹组的肿瘤直径[(1.55±0.66)cm vs(1.57±0.54)cm]、术中出血量[(47.85±40.03)mL vs(57.89±34.73)mL]、手术时间[(177.30±63.00)min vs(161.38±51.91)min]、术后住院天数[(13.0±5.39)d vs(15.97±8.91)d],未见明显统计学差异。腹腔镜组并发症仅见1例胰漏,开腹组合并胰漏3例,术后出血1例,胸腹腔积液8例,其他并发症4例,前者明显优于后者(P<0.05)。术后随访中,腹腔镜组随访3~65个月,复发1例(46个月),开腹组随访6~69个月,复发2例,平均复发时间为34.5个月,但未达到统计学差异。结论胰体和胰尾的胰岛素瘤行腹腔镜下单纯切除,是一种安全且有效的手术方式,相对于传统开腹有并发症少、术后住院天数略缩短、复发时间略延长等优点。
Objective To assess the safety of laparoscopic insulinoma resection and to compare the clinical characteristics of laparoscopic and open excision of insulinoma. Methods A total of 51 cases of insulinoma from July 2004 to November 2013 were retrospectively collected. Laparoscopic insulinoma resection (laparoscopic group, 14 cases) and open excision of insulinoma Abdominal group, 37 cases). The operation time, intraoperative blood loss, postoperative hospital days and complication were compared. Results The tumor diameter in laparoscopic group and open group was (1.55 ± 0.66) cm vs (1.57 ± 0.54) cm, and the intraoperative blood loss was (47.85 ± 40.03) mL vs (57.89 ± 34.73) mL, [(177.30 ± 63.00) min vs (161.38 ± 51.91) min], postoperative hospital stay [(13.0 ± 5.39) d vs (15.97 ± 8.91) d], respectively, and no significant difference was found. In laparoscopic group, only 1 patient had pancreatic leakage, 3 patients had laparotomy combined with pancreatic leakage, 1 patient had postoperative bleeding, 8 patients had pleural effusion and ascites, and 4 patients had other complications. The former was significantly better than the latter (P <0.05) . During the follow-up period, laparoscopic group was followed up for 3 to 65 months, with 1 case of recurrence (46 months) and 6 to 69 months of follow-up in open group, with 2 cases of recurrence. The average recurrence time was 34.5 months but did not reach the statistics Differences Conclusions Insulinoma of pancreas and tail is simple and laparoscopic resection, which is a safe and effective surgical method. Compared with traditional open laparotomy, there are fewer complications, shorter postoperative hospital days and longer recurrence time.