How to implement minimally invasive duodenumpreserving total pancreatic head resection for patients with pancreatic head lesions A retrospective study
Аннотация
Laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) has been widely reported. However, due to the
challenges involved in performing total pancreatic head resection during operation, there are few studies reporting it. Between
November 2016 and October 2022, we performed laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt)
on 64 patients in the Department of Hepatobiliary Surgery, the Second Hospital of Hebei Medical University. Perioperative data
of the patients such as age, gender, body mass index, operation time, blood loss, and postoperative hospital stay were collected
and analyzed. This study included 40 women and 24 men aged 41.4 ± 15.7 years. All patients completed the surgery, and none
of the patients underwent laparotomy. The average operation time was 275 (255, 310) min. The average postoperative hospital
stay was 12 (10, 16) days. The rate of occurrence of pancreatic fistula was 10.9% (7/64), and that of the biliary fistula was 9.4%
(6/64). One of the patients underwent cholangiojejunostomy 3 months after the operation due to painless jaundice and bile duct
dilatation. By dissecting the space between the pancreatic head and duodenum, the posterior pancreatic duodenal arterial arch
and the surface vascular network of the common bile duct (CBD) can be preserved. This ensures the success of LDPPHRt and
avoids postoperative complications in the absence of intraoperative image guidance.
resection, IPMN = intraductal papillary mucinous neoplasia, LDPPHRt = laparoscopic duodenum-preserving total pancreatic head
resection, MPD = main pancreatic duct, PD = pancreaticoduodenectomy, PJ = pancreaticojejunostomy.
Keywords: duodenum-preserving, laparoscopic, total pancreatic head resection
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Об авторах
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