【摘要】 背景与目的：保留十二指肠全胰头切除术（DPPHR）胰头良性或低恶性占位病常见的术式选择，尽管腹腔镜胰腺手术已日趋成熟，但传统腹腔镜下进行该手术仍有相当大的难度。近年来，3D腹腔镜技术的出现，克服了传统腹腔镜的短板，使得腹腔镜手术更精细、更安全。本研究总结4例荧光显影引导的3D腹腔镜下行DPPHR的经验，以期为该术式的应用与推广提供参考。方法：回顾性分析湖南省湘西土家族苗族自治州人民医院肝胆外科2019年8月—2021年5月4例行荧光显影导航下3D腹腔镜DPPHR的患者临床资料。结果：4例患者均成功实施荧光导航下3D腹腔镜DPPHR，手术时间370～510 min；出血量80～300 mL；均未输注红细胞和血浆。术后1例患者发生迟发性胃排空障碍，经留置鼻空肠营养管等措施后治愈，2例患者发生A级生化漏，无十二指肠穿孔、胆汁漏、出血、二次手术等并发症发生。4例患者术后随访3～24个月，均恢复良好。结论：选择合适病例，在经验较丰富的胰腺外科中心开展荧光导航下3D腹腔镜DPPHR是安全可行的。更多还原

【Abstract】 Background and Aims:Duodenum-preserving pancreatic head resection(DPPHR) is a commonly used option for benign or low-grade malignant space-occupying lesions of the head of the pancreas.Despite advances in laparoscopic techniques,performing this procedure under traditional laparoscopic approaches is still considerably challenging.In recent years,the emergence of 3 D laparoscopic techniques overcomes the shortcomings of traditional laparoscopic methods and makes laparoscopic surgery more precise and safer.Here,the authors summarize the experience in 4 cases undergoing 3 D laparoscopic DPPHR guided by fluorescence imaging,so as to provide a reference for the application and promotion of this technique.Methods:The clinical data of 4 patients who underwent 3 D laparoscopic laparoscopic DPPHR under fluorescence imaging navigation from August 2019 to May 2021 in the People’s Hospital of Xiangxi Tujia and Miao Autonomous Prefecture were analyzed retrospectively.Results:The 3 D laparoscopic DPPHR under fluorescence imaging navigation was successfully completed in all 4 patients.The operative time was 370-510 min,and the blood loss was 80-300 m L,with no transfusion requirements of red blood cells and plasma.After the operation,one patient developed delayed gastric emptying,which was resolved by inserting a nasojejunal nutrition tube,2 patients developed grade A biochemical leakage,and there were no complications such as duodenal perforation,postoperative bile leakage,postoperative bleeding,and secondary operation.All 4 patients were followed up for 3-24 months and recovered well.Conclusion:Performing 3 D laparoscopic DPPHR guided by fluorescence imaging is safe and feasible with the appropriate selection of patients in an experienced pancreatic surgery center.更多还原