Analysis of the safety and feasibility of combined portal vein system resection and reconstruction in laparoscopic pancreaticoduodenectomy
10.3760/cma.j.cn113884-20241015-00302
- VernacularTitle:联合门静脉系统切除重建LPD的安全性和可行性分析
- Author:
Chengxu DU
1
;
Haotian YU
1
;
Dongrui LI
1
;
Weihong ZHAO
1
;
Jianhua LIU
1
;
Jiansheng ZHANG
1
;
Wenbin WANG
1
;
Wei BIAN
1
;
Haitao LYU
1
Author Information
1. 河北医科大学第二医院肝胆外科，石家庄 050000
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Vascular resection and reconstruction;
Pancreaticoduodenectomy
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(2):107-110
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with portal vein system resection and reconstruction.Methods:The clinical data of 26 patients with pancreatic head cancer or distal bile duct malignant tumors who underwent reconstructive LPD combined with portal vein resection in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2016 to December 2023 were retrospectively analyzed, including 13 males and 13 females, aged 63.0 (57.2, 66.0) years. The clinical data of the patients, including the operation time, intraoperative blood loss and blood transfusion, blood flow interruption time, postoperative complications, intensive care unit (ICU) admission time, and hospital stay were recorded.Results:All 26 patients had completed the operation successfully. The operation time was (483.65±118.00) min, the intraoperative blood loss was 1 100 (625, 2 750) ml, the intraoperative blood transfusion was 600 (438, 1 050) ml, and the portal vein system blockade time was (35.00±6.00) min. There were 5 cases (19.2%, 5/26) with laparotomy, 5 cases (19.2%%, 5/26) with repair after partial resection of the portal vein system, 12 cases (46.1%, 12/26) with end-to-end anastomosis of the portal venous system, and 9 cases (34.6%, 9/26) with artificial vascular replacement. There was 1 case of grade B pancreatic fistula (3.8%, 1/26), 3 cases of bile leakage (11.5%, 3/26), 1 case of gastric paralysis (3.8%, 1/26), 3 cases of intestinal obstruction (11.5%, 3/26), 2 cases of abdominal infection (7.7%, 2/26), 2 cases of postoperative bleeding (7.7%, 2/26), 1 case of secondary surgery (3.8%, 1/26), and 1 case of perioperative death (3.8%, 1/26). The postoperative hospital stay was 14.00 (12.00, 20.75) d, the ICU length of stay was 3.0 (1.0, 6.5) d, the tumor length diameter was 4.00 (3.00, 5.38) cm, and the number of positive lymph nodes was 1.0(0.5, 3.5).Conclusion:LPD reconstructed with portal system resection is a safe and effective treatment of patients with pancreatic head cancer or distal bile duct malignancy.
