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目的 :比较腹腔镜和开腹手术治疗胰体尾肿瘤的临床疗效。方法 :回顾性分析我院2012年10月至2013年12月92例胰腺良性或交界性肿瘤病人的临床资料,其中42例行腹腔镜远端胰腺切除术(laparoscopic distal pancreatectomy,LDP),含10例保留脾脏,50例行开腹远端胰腺切除术(open distal pancreatectomy,ODP),含3例保留脾脏。比较两组病人一般资料、手术时间、术中出血量、住院天数、术后并发症及住院费用。结果 :LDP组与ODP组病人一般情况基本一致,LDP组体质量指数显著高于ODP组(24.79比23.18,P=0.001)。LDP组手术时间较ODP组长,有统计学差异(153.19 min比119.19 min,P<0.001)。LDP组术中出血量、进食开始时间、术后住院天数均明显低于ODP组,差异有统计学意义(P<0.05)。两组术后胰漏发生率无统计学差异(33.3%比36.0%,P>0.05),LDP组住院费用较ODP组高,但无统计学差异(4.49万元比4.29万元,P>0.05)。结论 :LDP对于良性或交界性胰体尾肿瘤的病人安全可行。
Objective: To compare the clinical efficacy of laparoscopic and open surgery in the treatment of pancreatic body and tail tumor. Methods: The clinical data of 92 patients with benign or borderline pancreatic tumors in our hospital from October 2012 to December 2013 were retrospectively analyzed. Among them, 42 patients underwent laparoscopic distal pancreatectomy (LDP) with 10 Spleen preservation was performed in 50 cases, open distal pancreatectomy (ODP) in 50 cases and spleen preservation in 3 cases. The general data, operation time, intraoperative blood loss, hospitalization days, postoperative complications and hospitalization costs were compared between the two groups. Results: The general situation of patients in LDP group and ODP group was basically the same. The body mass index in LDP group was significantly higher than that in ODP group (24.79 vs 23.18, P = 0.001). The operation time of LDP group was longer than that of ODP group (153.19 min vs. 119.19 min, P <0.001). The amount of blood loss, the time of onset of eating and the number of postoperative hospital stay in LDP group were significantly lower than those in ODP group (P <0.05). There was no significant difference between the two groups in the incidence of pancreatic leakage (33.3% vs 36.0%, P> 0.05). The hospitalization cost in LDP group was higher than that in ODP group, but there was no significant difference (44900 yuan vs 42900 yuan, P> 0.05 ). Conclusion: LDP is safe and feasible for patients with benign or borderline pancreas and tail tumor.