Application of "priority approach of uncinate process" in laparoscopic pancreaticoduodenectomy:A report of 200 cases
10.19538/j.cjps.issn1005-2208.2019.12.20
- Author:
Qing-min CHEN
1
;
Song-yang LIU
1
;
Ying-chao WANG
1
;
Ya-hui LIU
1
Author Information
1. No.2 Department of Hepatobiliarypancreatic Surgery, the First Hospital of Jilin University Changchun 130021,China
- Publication Type:Journal Article
- Keywords:
pancreaticoduodenectomy;
laparoscopic technique;
surgical approach
- From:
Chinese Journal of Practical Surgery
2019;39(12):1321-1325
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To explore the value of "priority approach of uncinate process" in laparoscopic pancreaticoduodenectomy. METHODS: The data of 200 patients who underwent laparoscopic pancreaticoduodenectomy in the No.2 Department of Hepatobiliarypancreatic Surgery, the First Hospital of Jilin University from April 2015 to October 2018 were analyzed retrospectively. RESULTS: All the 200 patients successfully completed laparoscopic pancreaticoduodenectomy, including 1 case of laparoscopic pancreaticoduodenectomy combined with right hemicolectomy,2 cases of laparoscopic pancreaticoduodenectomy combined with pancreaticocotailectomy,and 2 cases of laparoscopic pancreaticoduodenectomy combined with portal vein reconstruction(end-to-end anastomosis). The mean operation time was(281±49)min,including the specimen removal time(91±15)min,and the intraoperative blood loss was 50-850 mL(122±53)mL. The mean postoperative hospital stay was(16±9)days. Eight-teen cases(9.0%)had grade B pancreatic fistula and 3 cases(1.5%)had grade C pancreatic fistula. Postoperative anastomotic bleeding in 2 cases(1.0%). Intraperitoneal hemorrhage was found in 14 cases(7.0%), and delayed gastric emptying in 9 cases(4.5%).Biliary fistula was found in 11 cases(5.5%). There were 2 deaths(1.0%). Postoperative pathological diagnosis showed that ductal adenocarcinoma of the head of pancreas was in 33 cases(16.5%),the pancreas intraductal papillary mucinous tumor in 15 cases(7.5%),head of the pancreatic neuroendocrine tumors in 6 cases(3.0%),pancreatic ductal epithelial hyperplasia in 1 case(0.5%),solid pancreatic head fake papilloma in 9 cases(4.5%),pancreatic head capsule adenomas in 5 cases(2.5%),chronic pancreatitis in 1 case(0.5%),duodenal adenocarcinoma in 4 cases(2.0%), duodenal stromal tumor in 2 cases(1.0%), duodenal benign space-occupying lesions in 11 cases(5.5%),periampullary carcinoma of non pancreatic head origin in 105 cases(52.5%)and benign periampullary tumors in 9 cases(4.5%). CONCLUSION: "Priority approach of uncinate process" is safe,rapid and effective in laparoscopic pancreaticoduodenectomy,which is worthy of further promotion and application in clinic.
