Clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy for periampullary tumor
10.3760/cma.j.issn.1673-4904.2019.01.005
- VernacularTitle:壶腹周围癌行腹腔镜胰十二指肠切除术时动脉优先入路的应用探讨
- Author:
Qingchun LI
1
;
Junhua XUE
;
Wenge LI
Author Information
1. 陕西省渭南市第一医院普外科 714000
- Keywords:
Ampulla of vater;
Laparoscopy;
Pancreaticoduodenectomy;
Arterial first approach
- From:
Chinese Journal of Postgraduates of Medicine
2019;42(1):14-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy (LPD) for periampullary tumor. Methods The data of 134 patients with periampullary tumor who had underwent LPD between February 2014 and August 2017 were collected. The patients were divided into 2 groups by random digital table method, with 67 cases in each group. The experimental group received arterial first approach LPD, and the control group received traditional approach LPD. The intraoperative, postoperative and survival situations were compared between 2 groups. Follow- up using outpatient examination and telephone interview was performed to detect the tumor- free survival up to February 2018. Results All the patients underwent successful LPD. The time of tumor resection with superior mesenteric venous invasion, volume of intraoperative blood loss and volume of blood transfusion in experimental group were significantly lower than those in control group: (215.6 ± 12.3) min vs. (263.4 ± 21.2) min, (98.9 ± 15.6) ml vs. (130.1 ± 26.7) ml and (1.4 ± 0.9) U vs. (2.9 ± 1.3) U, and there were statistical differences (P<0.05). The rate of R0 resection in experimental group was significantly higher than that in control group: 97.0％ (65/67) vs. 88.1％ (59/67), and there was statistical difference (P<0.05). There was no statistical difference in postoperative 6- month tumor- free survival rate between 2 groups (P>0.05). Conclusions Arterial first approach in LPD can significantly reduce the volumes of intraoperative blood loss and blood transfusion, shorten the time of tumor resection with superior mesenteric venous invasion, and increase the rate of R0 resection.
