目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性结石嵌顿性胆囊炎的可行性。方法:总结分析2007年10月至2009年6月36例急性结石嵌顿性胆囊炎行腹腔镜胆囊切除术的经验体会,包括手术适应证及手术技巧等。结果:35例(972％)成功完成腹腔镜胆囊切除术,1例(28％)中转开腹,无胆管、肠管损伤,无术后出血及围手术期(术后30天)死亡等并发症,均获治愈。术后随访4月～23月无手术并发症。结论:在术者熟练的操作技巧,合理选择中转开腹时机的前提下,急性结石嵌顿性胆囊炎行腹腔镜胆囊切除术安全、可行。
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.
ObjectiveTo evaluate the feasibility and safety of laparoscopic radical antegrade modular pancreatosplenectomy through the ligament of Treitz approach for pancreatic body and tail cancer. MethodsOn 13th November 2017, we selected a patient with a suspicious malignant tumor in the body of pancreas but no evidence of metastasis or local invasion of the retroperitoneum for laparoscopic antegrade modular pancreatosplenectomy through the ligament of Treitz approach. The time of operation, the estimated blood loss, and post-operative complications were observed. ResultsThe procedure was completed successfully in 255 min, and the estimated blood loss was 200 mL, there was no need of transfusion and no significant post-operational complications had been observed. No tumor recurrence or distal metastasis was found after a 12 month’s follow-up. ConclusionLaparoscopic radical antegrade modular pancreatosplenectomy through the ligament of Treitz approach is a feasible and safe procedure for pancreatic body and tail malignant tumor in strictly selected patients.
Objective To explore the feasibility and safety of Frey operation under laparoscopy in the treatment of chronic pancreatitis. Methods The clinical data of chronic pancreatitis patients who underwent laparoscopic Frey procedure in Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University from 2021-2023 were retrospectively analyzed. Results Eleven patients with chronic pancreatitis complicated with pancreatic duct stones were included in the study, 7 of whom had a history of diabetes and (or ) impaired glucose tolerance, suggesting that pancreatic endocrine function was impaired. The median diameter of the main pancreatic duct measured by imaging method was 8 mm (4–20mm). The median operative time was 188 min (120–368 minutes), and the total intraoperative bleeding volume was 50 mL (20–100 mL). Postoperative pancreatic fistula did not occur, one case of postoperative abdominal fluid accumulation and hypoproteinemia improved after symptomatic supportive treatment such as anti infection, acid and enzyme inhibition, and nutritional rehydration. Postoperative bleeding occurred in 3 cases, including 1 case of intestinal anastomotic bleeding, which was sutured again under emergency laparoscopic intestinal anastomosis to stop bleeding. The other two cases improved after conservative management such as blood transfusion, plasma, vitamin K, acid inhibition, enzyme inhibition and hemostatic drugs. The median postoperative hospitalization time was 7 days (4–18 days), and no patient mortality happened within 90 days after surgery. Conclusion Laparoscopic Frey operation is feasible and a relatively safe and effective method for the treatment of chronic pancreatitis.