【作者】 胡智明； 蔡涵晖； 吴伟顶； 张宇华； 张军港； 沈国樑； 成剑； 尚敏杰； 王强； 姚伟锋； 刘杰； 张成武； 黄东胜；

【机构】 浙江省人民医院；

【摘要】 目的 :探讨腹腔镜联合输尿管软镜钬激光在治疗慢性胰腺炎胰管结石中的安全性和有效性。方法 :回顾性分析2012年1月至2018年8月浙江省人民医院外科收治的58例慢性胰腺炎胰管结石患者,选取其中行腹腔镜胰管纵形切开取石+胰管空肠Roux-en-Y吻合术的31例患者作为研究对象,分为两组,腹腔镜联合钬激光碎石治疗组(10例,A组)和腹腔镜治疗组(21例,B组),对其手术时间、术中出血量、术中中转开腹率、胰管切开长度、术后胰瘘发生率、术后住院天数、结石残留率进行统计分析。结果 :全组31例患者中转手术3例(3/31),均临床治愈出院,无围手术期死亡。两组的胰管切开长度、手术时间、术后住院天数比较差异有统计学意义(P <0.05);两组中转开腹率、术中出血量、术后胰瘘发生率、结石残留率比较,差异无统计学意义(P> 0.05)。结论 :腹腔镜治疗慢性胰腺炎胰管结石是安全可行的;如联合输尿管软镜钬激光碎石具有胰肠吻合口内径适中、手术时间短、术后住院天数少等优点。更多还原

【Abstract】 Objective :To explore the safety and feasibility of laparoscopy combined with holmium laser in chronic pancreatitis complicated with pancreatic duct stones.Methods:A retrospective study was conducted to analyze the clinical data of laparoscopy combined with holmium laser(10 patients,A group) and laparoscopy(21 patients,B group)in Zhejiang Provincial People’s Hospital from January 2012 to August 2018.The operation time,intraoperative blood loss,intraoperative conversion rate,pancreatic duct incision length,postoperative pancreatic fistula incidence,postoperative hospital stay and stone residual rate data of the two groups were documented and analyzed.Results :There were 3 patients conversed.All patients of the two groups were all clinically cured and discharged without perioperative death.There were significant differences in pancreatic duct incision length,operation time,postoperative hospital stay in the two groups(P<0.05).There were no significant differences in intraoperative conversion rate,intraoperative blood loss,postoperative pancreatic fistula incidence and and residual rate of stones in the two groups(P >0.05).Conclusion :It is safe and feasible to treat chronic pancreatitis complicated with pancreatolithiasis by laparoscopy.Laparoscopy combined with holmium laser has the advantages of more moderate inside diameter of pancreaticojejunostomy,shorter operation time,less intraoperative blood loss.更多还原