腹腔镜胰十二指肠切除术治疗壶腹周围肿瘤的经验

S. Tileuov, A. Dzhumabekov, B. Baimakhanov, M. Doskhanov, A. Chormanov, Sh.M. Teipov, B. Askeev
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摘要

本研究旨在探讨腹腔镜胰十二指肠切除术治疗壶腹周围肿瘤的可行性。材料和方法。2016年至2022年期间,在Syzganov国家外科科学中心,193例诊断为壶腹周围区肿瘤的PD患者接受了PD治疗。其中6例患者行腹腔镜手术。所有接受LPD的患者均为女性。患者年龄15 ~ 77岁,平均年龄55.5岁。结果。壶腹癌4例(66.7%),胰头癌2例(33.3%)。根据最终组织学资料,所有病例均检测到腺癌及分化程度G2。表1总结了肿瘤的组织学和大小数据。患者平均年龄55.7岁。所有患者术前均有机械性黄疸门诊;血液中胆红素的平均水平为121.3 mmol/l。因此,所有患者均行胆道引流。其中5例(83.3%)行经皮支架植入术,1例(16.7%)行胆道内支架植入术。结论。因此,我们提出了执行腹腔镜PD的初步经验。我们的结果表明,在某些情况下,腹腔镜PD安全、彻底地治疗壶腹周围肿瘤是可行的。这些干预措施经验的积累可以改善即时效果,减少术后并发症和手术时间。
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OUR EXPERIENCE OF LAPAROSCOPIC PANCREATODUODENECTOMY IN TUMORS OF THE PERIAMPULLARY ZONE
The purpose of research is to determine the feasibility of laparoscopic pancreatoduodenectomy in tumors of the periampullary zone. Material and methods. In the period from 2016 to 2022 at the Syzganov National Scientific Center of Surgery, 193 patients underwent PD with a diagnosis of a tumor of the periampullary zone. Of these, 6 patients were performed laparoscopically. All patients who underwent LPD were female. The age of the patients ranged from 15 to 77 years (average age – 55,7 years). Results. In 4 (66.7%) patients, cancer of Ampulla of Vater was detected, in 2 (33.3%) pancreatic head cancer. According to the final histology data, adenocarcinoma and the degree of differentiation G2 were detected in all cases. Data on the histology and size of the tumor are summarized in Table 1. The average age of patients was 55.7 years. All patients had a clinic of mechanical jaundice before surgery; the average levels of bilirubin in the blood were 121.3 mmol/l. Accordingly, all patients underwent drainage of the biliary tract. Of these, 5 (83.3%) patients underwent percutaneous stenting and 1 (16.7%) endobiliary stenting. Conclusion. Thus, we presented our initial experience of performing laparoscopic PD. Our results shows the feasibility of laparoscopic PD safely and radically for tumors of the periampullary zone in certain cases. The accumulation of experience in such interventions leads to an improvement in immediate results and a reduction in postoperative complications, the operative time.
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