自1985年第一例腹腔镜胆囊切除术成功，腹腔镜逐渐成为治疗结石性胆囊疾病的金标准。近10年来其应用范围迅速扩展，并被广大普外科医生接受和认可，开创了医学领域高速发展的历史新纪元。急腹症是指能够引起急腹痛的腹腔内急性病变，要求外科医生做出快速、准确判断，而不允许花费更多的时间做全面的辅助检查。要想做出快速诊断又不耽误病情，近年来微创外科同行认识到腹腔镜兼有诊断和治疗的特点，在外科急腹症中发挥了重要的作用，现分述之。
ObjectiveThis review aimed to summarize the current epidemiological status and risk factors of pancreatic cancer at home and abroad.MethodThe literatures on epidemiology and risk factors of pancreatic cancer in recent years were collected and summarized.ResultsCurrently the overall incidence of pancreatic cancer was lower in all malignant tumors, but the mortality rate was the opposite. Incidence varies from region to region, the incidence rate in economically developed areas was higher than that of underdeveloped areas. Although the disease had made some progress in the fields of surgery, chemotherapy, an so on, the long-term survival of patients with pancreatic cancer was still not ideal. The onset of pancreatic cancer was associated with smoking, alcohol, obesity, dietary imbalance, age, gender, blood type, ethnicity, family history and genetic history, chronic pancreatitis, infection, and intestinal flora imbalance.ConclusionsPancreatic cancer is a high malignancy with a poor prognosis. It is influenced by a variety of risk factors. Therefore, it is especially necessary to pay attention to the primary prevention of pancreatic cancer and screen high-risk individuals regularly, to diagnose pancreatic cancer at an early stage.
ObjectiveTo investigate the occurrence and treatment of postoperative complications after laparoscopic laparoscopic pylorus-preserving pancreaticoduodenectomy (LPPPD) or pancreaticoduodenectomy (LPD). MethodThe clinical data of 130 patients undergoing LPD from October 2010 to December 2015 in West China Hospital of Sichuan University were analyzed retrospectively. ResultsOf 130 patients, postoperative complications occurred in 55 cases, including 24 cases of pancreatic fistula, 14 cases of gastric emptying disorder, 3 cases of anastomotic bleeding, 6 cases of peritoneal infection, 1 case of bile leakage, 1 case of venous thrombosis, 1 case of chylous leakage, 5 cases of peritoneal effusion, without the occurrence of stress ulcer and incision complications. There were significant difference in the incidence of pancreatic fistula (P=0.025), gastric emptying disorder (P=0.034), anastomotic bleeding (P=0.020), and peritoneal infection (P=0.016) among prophase group, metaphase group, and the later stage group. ConclusionsThe most common complication after LPD is pancreatic fistula. With the improvement of surgical techniques and procedures, incidences of some postoperative complications decreases gradually.