Short-term outcome of Heidelberg triangle dissection in laparoscopic pancreaticoduodenectomy for pancreatic cancer
10.3760/cma.j.cn115667-20210202-00031
- VernacularTitle:海德堡三角清扫在腹腔镜胰十二指肠切除术治疗胰腺癌中的近期疗效
- Author:
Zhenyong WANG
1
;
Yu MENG
;
Jinchao LI
;
Lei ZHANG
;
Liang SHI
;
Ruhai LIU
;
Fengshan LI
Author Information
1. 河北省沧州市中心医院肝胆胰外一科，沧州 061000
- Keywords:
Pancreatic neoplasms;
Laparoscopy;
Pancreaticoduodenectomy;
Heidelberg triangle
- From:
Chinese Journal of Pancreatology
2021;21(4):282-286
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the short-term outcome of Heidelberg triangle dissection in laparoscopic pancreaticoduodenectomy (LPD) for pancreatic cancer.Methods:The clinical data of 84 patients with pancreatic head cancer who underwent LPD from July 2015 to September 2020 in the Department of Hepatobiliary and Pancreatic Surgery of the Cangzhou Central Hospital were retrospectively analyzed. According to the scope of surgical dissection, the patients were divided into the control group ( n=45) and the Heidelberg group ( n=39). In the control group, routine lymph node dissection was performed, and in the Heidelberg group, all blood vessels, lymphatic tissue and nerve tissue in the Heidelberg triangle area were dissected on the basis of routine lymph node dissection. Operation-related indicators (operation duration, intraoperative blood loss, cases of patients with intraoperative blood transfusion, fasting time and hospitalization duration after operation), postoperative complications (pancreatic fistula, biliary fistula, lymphatic fistula, bleeding and delayed gastric emptying) and postoperative pathological parameters (surgical margin, degree of differentiation, tumor size, cases of nerve invasion, number of dissected lymph nodes, lymph node metastasis and TNM stage) were compared between the two groups. Results:Compared with the control group, the operation time of the Heidelberg group was longer [ (334.85±24.95)min vs (305.09±24.54)min], theincidence of lymphatic fistula was higher (15.4% vs 2.2%), the rate of >1 mm at surgical margin was higher (76.9% vs 53.3%), and the total number of lymph nodes dissection was more [ (11.31±2.46) vs (9.49±2.28)]. All the differences between the two groups were statistically significant ( P<0.05). However, there were no significant differences on the intraoperative blood loss, cases of patients with intraoperative blood transfusion, postoperative hospital stay and fasting time, incidence of pancreatic fistula and biliary fistula, bleeding, delayed gastric emptying, degree of differentiation, tumor size, cases of nerve invasion, lymph node metastasis and TNM stage between the two groups. Conclusions:LPD combined with Heidelberg triangle dissection for pancreatic cancer was feasible and safe, which can increase the R 0 resection rate, remove more lymph nodes, reduce the local recurrence of pancreatic cancer and improve the prognosis of patients.
