腹腔鏡手術在慢性胰腺炎治療中的應用_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

曾新桃 ,  楊培 , 羅華 , 楊東芹 , 李超

電子科技大學醫學院附屬綿陽醫院?綿陽市中心醫院肝膽外科（四川綿陽 ?621000）;

Corresponding?author：

楊培, Email: yppppy@126.com

Keywords：

慢性胰腺炎; 腹腔鏡; 胰瘺

DOI：

10.7507/1007-9424.202203019

Video：

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目的探討腹腔鏡手術治療慢性胰腺炎的安全性及可行性。方法收集2015年1月至2020年12月期間采用腹腔鏡手術治療的21例慢性胰腺炎患者的臨床資料，其中胰管結石伴主胰管梗阻10例，胰頭部腫塊形成7例，胰腺實質明顯萎縮4例。結果中轉開腹3例；手術時間175～430 min（中位數305 min），術中出血量100～800 mL（中位數260 mL）。手術方式包括腹腔鏡胰十二指腸切除術8例，腹腔鏡胰管切開取石聯合空腸吻合術（Partington術）5例，腹腔鏡全胰十二指腸切除術4例，腹腔鏡改良Beger術2例，腹腔鏡胰體尾切除術2例（1例保留脾臟）。術后腹腔引流管拔除時間2～14 d（中位數8 d）。術后出現生化瘺3例，胃排空延遲2例。術后住院時間6～21 d（中位數9 d）。圍手術期無死亡病例，無B、C級胰瘺，無非計劃再次手術發生。隨訪12～84個月（中位數36個月），無胰腺惡性腫瘤發生，無脾梗死。結論腹腔鏡手術治療慢性胰腺炎安全可行。

Citation： 曾新桃, 楊培, 羅華, 楊東芹, 李超. 腹腔鏡手術在慢性胰腺炎治療中的應用. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(10): 1355-1358. doi: 10.7507/1007-9424.202203019 Copy

1.	Issa Y, Kempeneers MA, Bruno MJ, et al. Effect of early surgery vs endoscopy-first approach on pain in patients with chronic pancreatitis: The ESCAPE randomized clinical trial. JAMA, 2020, 323(3): 237-247.
2.	Ratnayake CBB, Kamarajah SK, Loveday BPT, et al. A network meta-analysis of surgery for chronic pancreatitis: impact on pain and quality of life. J Gastrointest Surg, 2020, 24(12): 2865-2873.
3.	Matsumoto I, Kamei K, Murase T, et al. Surgical treatment for chronic pancreatitis: a single-center retrospective study in Japan. J Hepatobiliary Pancreat Sci, 2020, 27(9): 632-639.
4.	Ni Q, Yun L, Roy M, et al. Advances in surgical treatment of chronic pancreatitis. World J Surg Oncol, 2015, 13: 34. doi: 10.1186/s12957-014-0430-4.
5.	孔祥虎, 韓瑋, 李秋影. 胰體尾切除術后胰瘺影響因素的多因素分析. 中國普外基礎與臨床雜志, 2020, 27(6): 708-713.
6.	Gumbs AA, Daskalaki D, Milone L. Laparoscopic total pancreatectomy for chronic pancreatitis. Surg Laparosc Endosc Percutan Tech, 2018, 28(2): e62. doi: 10.1097/SLE.0000000000000519.
7.	Ramia JM, Azagra JS, De la Plaza R, et al. Laparoscopic longitudinal pancreaticojejunostomy for chronic pancreatitis: Systematic review of the literature. Surgeon, 2020, 18(3): 137-141.
8.	Kilburn DJ, Chiow AKH, Leung U, et al. Early experience with laparoscopic frey procedure for chronic pancreatitis: a case series and review of literature. J Gastrointest Surg, 2017, 21(5): 904-909.
9.	Cai H, Cai Y, Wang X, et al. Laparoscopic Beger procedure for the treatment of chronic pancreatitis: a single-centre first experience. BMC Surg, 2020, 20(1): 84. doi: 10.1186/s12893-020-00750-7.
10.	王敏, 石喻, 郭啟勇. 慢性胰腺炎影像學診斷現狀及研究進展. 中國醫科大學學報, 2019, 48(7): 652-656.
11.	趙子慧, 梁燦燦, 姚萍. 3種無創影像學檢查診斷慢性胰腺炎價值比較. 中華實用診斷與治療雜志, 2013, 27(6): 583-584.
12.	陸子鵬, 蔣奎榮, 苗毅. 慢性胰腺炎疼痛治療的“內外之爭”. 中華胰腺病雜志, 2020, 20(5): 350-352.
13.	蔡涵暉, 胡智明, 吳偉頂, 等. 腹腔鏡聯合鈥激光碎石治療慢性胰腺炎合并胰管結石. 中華肝膽外科雜志, 2019, 25(3): 207-210.
14.	Blumentrath CG, Ewald N, Petridou J, et al. The sword of Damocles for the splenectomised: death by OPSI. Ger Med Sci, 2016, 14: Doc10. doi: 10.3205/000237.
15.	劉小鵬, 徐建, 鄔長康, 等. 腹腔鏡下保留脾臟胰體尾切除術技術探討及臨床應用體會. 中國普外基礎與臨床雜志, 2021, 28(2): 189-193.
16.	熊志勇, 龔朕, 姚志成, 等. 全胰腺切除術在胰腺疾病治療中的應用進展. 中華肝臟外科手術學電子雜志, 2015, 4(6): 379-382.
17.	Fan CJ, Hirose K, Walsh CM, et al. Laparoscopic total pancreatectomy with islet autotransplantation and intraoperative islet separation as a treatment for patients with chronic pancreatitis. JAMA Surg, 2017, 152(6): 550-556.

1. Issa Y, Kempeneers MA, Bruno MJ, et al. Effect of early surgery vs endoscopy-first approach on pain in patients with chronic pancreatitis: The ESCAPE randomized clinical trial. JAMA, 2020, 323(3): 237-247.
2. Ratnayake CBB, Kamarajah SK, Loveday BPT, et al. A network meta-analysis of surgery for chronic pancreatitis: impact on pain and quality of life. J Gastrointest Surg, 2020, 24(12): 2865-2873.
3. Matsumoto I, Kamei K, Murase T, et al. Surgical treatment for chronic pancreatitis: a single-center retrospective study in Japan. J Hepatobiliary Pancreat Sci, 2020, 27(9): 632-639.
4. Ni Q, Yun L, Roy M, et al. Advances in surgical treatment of chronic pancreatitis. World J Surg Oncol, 2015, 13: 34. doi: 10.1186/s12957-014-0430-4.
5. 孔祥虎, 韓瑋, 李秋影. 胰體尾切除術后胰瘺影響因素的多因素分析. 中國普外基礎與臨床雜志, 2020, 27(6): 708-713.
6. Gumbs AA, Daskalaki D, Milone L. Laparoscopic total pancreatectomy for chronic pancreatitis. Surg Laparosc Endosc Percutan Tech, 2018, 28(2): e62. doi: 10.1097/SLE.0000000000000519.
7. Ramia JM, Azagra JS, De la Plaza R, et al. Laparoscopic longitudinal pancreaticojejunostomy for chronic pancreatitis: Systematic review of the literature. Surgeon, 2020, 18(3): 137-141.
8. Kilburn DJ, Chiow AKH, Leung U, et al. Early experience with laparoscopic frey procedure for chronic pancreatitis: a case series and review of literature. J Gastrointest Surg, 2017, 21(5): 904-909.
9. Cai H, Cai Y, Wang X, et al. Laparoscopic Beger procedure for the treatment of chronic pancreatitis: a single-centre first experience. BMC Surg, 2020, 20(1): 84. doi: 10.1186/s12893-020-00750-7.
10. 王敏, 石喻, 郭啟勇. 慢性胰腺炎影像學診斷現狀及研究進展. 中國醫科大學學報, 2019, 48(7): 652-656.
11. 趙子慧, 梁燦燦, 姚萍. 3種無創影像學檢查診斷慢性胰腺炎價值比較. 中華實用診斷與治療雜志, 2013, 27(6): 583-584.
12. 陸子鵬, 蔣奎榮, 苗毅. 慢性胰腺炎疼痛治療的“內外之爭”. 中華胰腺病雜志, 2020, 20(5): 350-352.
13. 蔡涵暉, 胡智明, 吳偉頂, 等. 腹腔鏡聯合鈥激光碎石治療慢性胰腺炎合并胰管結石. 中華肝膽外科雜志, 2019, 25(3): 207-210.
14. Blumentrath CG, Ewald N, Petridou J, et al. The sword of Damocles for the splenectomised: death by OPSI. Ger Med Sci, 2016, 14: Doc10. doi: 10.3205/000237.
15. 劉小鵬, 徐建, 鄔長康, 等. 腹腔鏡下保留脾臟胰體尾切除術技術探討及臨床應用體會. 中國普外基礎與臨床雜志, 2021, 28(2): 189-193.
16. 熊志勇, 龔朕, 姚志成, 等. 全胰腺切除術在胰腺疾病治療中的應用進展. 中華肝臟外科手術學電子雜志, 2015, 4(6): 379-382.
17. Fan CJ, Hirose K, Walsh CM, et al. Laparoscopic total pancreatectomy with islet autotransplantation and intraoperative islet separation as a treatment for patients with chronic pancreatitis. JAMA Surg, 2017, 152(6): 550-556.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

腹腔鏡手術在慢性胰腺炎治療中的應用

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