Primary exploration of stage I anastomosis and T-tube fistulation in laparoscopic local resection of duodenal tumors
10.3760/cma.j.cn441530-20240619-00220
- VernacularTitle:一期吻合联合T管造瘘在腹腔镜下十二指肠肿瘤局部切除术中的初步探索
- Author:
Lijie LUO
1
;
Tao WANG
;
Xinrui YE
;
Xianzhe WANG
;
Zhuoxuan ZHANG
;
Zijing ZHANG
;
Yaohui PENG
;
Yan CHEN
;
Haiping ZENG
;
Haipeng TANG
;
Jiantao LIN
;
Weiqiang ZOU
;
Wei WANG
Author Information
1. 广州中医药大学第一附属医院胃肠外科，广州 510405
- Publication Type:Journal Article
- Keywords:
Duodenal tumor;
Local resection;
Stage I anastomosis;
T-tube fistulation;
Laparoscopic surgery
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(2):198-202
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the feasibility and safety of stage I anastomosis and T-tube fistulation in laparoscopic local resection of duodenal tumors.Methods:A descriptive case series study was used to retrospectively analyze the clinical diagnosis and treatment data of 14 patients with duodenal tumors who successfully underwent laparoscopic local resection of duodenal tumors + phase I anastomosis + T-tube ostomy in the Guangdong Provincial Hospital of Chinese Medicine and the First Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2021 to March 2024. The resection and reconstruction steps of laparoscopic local resection of duodenal tumor + phase I anastomosis + T-tube ostomy are as follows: (1) after the safe margin is clear, the duodenal tumor is completely removed in full thickness, and the specimen bag is taken out and sent to frozen section to determine the nature of the tumor and the negative margin; (2) Perforate the anterior duodenal wall below the tumor plane, place a 16# T tube, and fix it with laparoscopic purse string suture. The abdominal wall is led out through the duodenum, and the duodenal T tube fistulation is performed; (3) The duodenum was continuously sutured in a full-thickness transverse shape, and the seromuscular layer was strengthened to form a phase I anastomosis. The nutritional improvement of patients after operation was mainly observed, and the intraoperative situation and postoperative complications were recorded.Results:No conversion to laparotomy, postoperative emergency reoperation, intraoperative and postoperative complications occurred in 14 patients with duodenal tumors who completed laparoscopic local resection of duodenal tumors + phase I anastomosis + T-tube ostomy. The operation time was (225.43 ± 56.54) min, and the intraoperative blood loss was (72.14 ± 74.65) ml. The patient recovered well after operation, and no severe postoperative abdominal bleeding occurred. Postoperative gastrointestinal angiography showed that the anastomotic stoma was unobstructed, and there were no stenosis, anastomotic leakage and other related complications. There was no significant difference in serum albumin [(37.09 ± 3.53) g/L vs. (37.52 ± 4) g/L] and hemoglobin [(100.79 ± 31.93) g/L vs. (103.07 ± 19.6) g/L] between before and 1 week after operation ( P > 0.05). Conclusion:Laparoscopic local resection of duodenal tumor + phase I anastomosis + T-tube fistulation can be used as one of the safe and feasible improved methods for local resection of duodenal tumor to effectively reduce the occurrence of related complications.
