腹腔镜手术在慢性胰腺炎治疗中的应用_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

曾新桃 ,  杨培 , 罗华 , 杨东芹 , 李超

电子科技大学医学院附属绵阳医院•绵阳市中心医院肝胆外科（四川绵阳 621000）;

Corresponding author：

杨培, Email: yppppy@126.com

Keywords：

慢性胰腺炎; 腹腔镜; 胰瘘

DOI：

10.7507/1007-9424.202203019

Video：

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目的探讨腹腔镜手术治疗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月期间采用腹腔镜手术治疗的21例慢性胰腺炎患者的临床资料，其中胰管结石伴主胰管梗阻10例，胰头部肿块形成7例，胰腺实质明显萎缩4例。结果中转开腹3例；手术时间175～430 min（中位数305 min），术中出血量100～800 mL（中位数260 mL）。手术方式包括腹腔镜胰十二指肠切除术8例，腹腔镜胰管切开取石联合空肠吻合术（Partington术）5例，腹腔镜全胰十二指肠切除术4例，腹腔镜改良Beger术2例，腹腔镜胰体尾切除术2例（1例保留脾脏）。术后腹腔引流管拔除时间2～14 d（中位数8 d）。术后出现生化瘘3例，胃排空延迟2例。术后住院时间6～21 d（中位数9 d）。围手术期无死亡病例，无B、C级胰瘘，无非计划再次手术发生。随访12～84个月（中位数36个月），无胰腺恶性肿瘤发生，无脾梗死。结论腹腔镜手术治疗慢性胰腺炎安全可行。

Citation： 曾新桃, 杨培, 罗华, 杨东芹, 李超. 腹腔镜手术在慢性胰腺炎治疗中的应用. 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, 韩玮, 李秋影. 胰体尾切除术后胰瘘影响因素的多因素分析. 中国普外基础与临床杂志, 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, 郭启勇. 慢性胰腺炎影像学诊断现状及研究进展. 中国医科大学学报, 2019, 48(7): 652-656.
11.	赵子慧, 梁灿灿, 姚萍. 3种无创影像学检查诊断慢性胰腺炎价值比较. 中华实用诊断与治疗杂志, 2013, 27(6): 583-584.
12.	陆子鹏, 蒋奎荣, 苗毅. 慢性胰腺炎疼痛治疗的“内外之争”. 中华胰腺病杂志, 2020, 20(5): 350-352.
13.	蔡涵晖, 胡智明, 吴伟顶, 等. 腹腔镜联合钬激光碎石治疗慢性胰腺炎合并胰管结石. 中华肝胆外科杂志, 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.	刘小鹏, 徐建, 邬长康, 等. 腹腔镜下保留脾脏胰体尾切除术技术探讨及临床应用体会. 中国普外基础与临床杂志, 2021, 28(2): 189-193.
16.	熊志勇, 龚朕, 姚志成, 等. 全胰腺切除术在胰腺疾病治疗中的应用进展. 中华肝脏外科手术学电子杂志, 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, 韩玮, 李秋影. 胰体尾切除术后胰瘘影响因素的多因素分析. 中国普外基础与临床杂志, 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, 郭启勇. 慢性胰腺炎影像学诊断现状及研究进展. 中国医科大学学报, 2019, 48(7): 652-656.
11. 赵子慧, 梁灿灿, 姚萍. 3种无创影像学检查诊断慢性胰腺炎价值比较. 中华实用诊断与治疗杂志, 2013, 27(6): 583-584.
12. 陆子鹏, 蒋奎荣, 苗毅. 慢性胰腺炎疼痛治疗的“内外之争”. 中华胰腺病杂志, 2020, 20(5): 350-352.
13. 蔡涵晖, 胡智明, 吴伟顶, 等. 腹腔镜联合钬激光碎石治疗慢性胰腺炎合并胰管结石. 中华肝胆外科杂志, 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. 刘小鹏, 徐建, 邬长康, 等. 腹腔镜下保留脾脏胰体尾切除术技术探讨及临床应用体会. 中国普外基础与临床杂志, 2021, 28(2): 189-193.
16. 熊志勇, 龚朕, 姚志成, 等. 全胰腺切除术在胰腺疾病治疗中的应用进展. 中华肝脏外科手术学电子杂志, 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

腹腔镜手术在慢性胰腺炎治疗中的应用

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