• 山東大學(xué)齊魯醫(yī)院普通外科(濟南250012);

目的 　探討腹腔鏡手術(shù)在胰腺疾病中的臨床應(yīng)用效果。
方法 　對12例胰腺疾病患者施行腹腔鏡手術(shù)，其中包括胰腺囊性疾病9例，分別行保留脾臟的胰體尾切除術(shù)（4例）、胰體尾加脾臟切除術(shù)（2例）及單純胰腺囊腫切除術(shù)（3例）； 胰島素瘤2例，均行胰島素瘤切除術(shù)； 胰腺癌術(shù)后復(fù)發(fā)1例，行左側(cè)內(nèi)臟神經(jīng)離斷術(shù)。
結(jié)果 　所有手術(shù)均獲成功，其中完全腹腔鏡下手術(shù)8例，經(jīng)腹腔鏡輔助手術(shù)4例。平均手術(shù)時間225 min （100～420 min），平均出血量80 ml （2～150 ml）； 1例術(shù)后發(fā)生胰瘺，經(jīng)保守治療治愈； 術(shù)后平均住院時間7.2 d （5～13 d）。胰腺癌術(shù)后復(fù)發(fā)患者術(shù)后存活6個月，止痛效果滿意； 其余患者隨訪10～36個月，效果良好，無復(fù)發(fā)。
結(jié)論 　腹腔鏡手術(shù)治療部分胰腺疾病安全有效，具有創(chuàng)傷小、痛苦輕、恢復(fù)快、并發(fā)癥少等優(yōu)點，具有廣闊的應(yīng)用前景。

引用本文： 胡三元,王延磊,智緒亭,王磊,張光永. 腹腔鏡手術(shù)在胰腺疾病中的臨床應(yīng)用探討. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(5): 516-520. doi: 復(fù)制

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14. 　Leksowski K. Thoracoscopic splanchnicectomy for control of intractable pain due to advanced pancreatic cancer [J]. Surg Endosc， 2001; 15(2)∶129.
15. 　Le Pimpec Barthes F, Chapuis O, Riquet M, et al. Thoracoscopic splanchnicectomy for control of intractable pain in pancreatic cancer [J]. Ann Thorac Surg， 1998; 65(3)∶810.
16. 　Takahashi T, Kakita A, Izumika H, et al. Thoracoscopic splanchnicectomy for the relief of intractable abdominal pain [J]. Surg Endosc， 1996; 10(1)∶65.
17. 　Worsey J, Ferson PF, Keenan RJ, et al. Thoracoscopic pancreatic denervation for pain control in irresectable pancreatic cancer [J]. Br J Surg， 1993; 80(8)∶1051.
  1. 1. 　Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy [J]. Surg Endosc， 1994; 8(5)∶408.
  2. 2. 　Sussman LA, Christie R, Whittle DE. Laparoscopic excision of distal pancreas including insulinoma [J]. Aust N Z J Surg， 1996; 66(6)∶414.
  3. 3. 　Pearlstone DB, Feig BW, Mansfield PF. Port site recurrences after laparoscopy for malignant disease [J]. Semin Surg Oncol， 1999; 16(4)∶307.
  4. 4. 　牟一平, 徐曉武, 朱玲華， 等. 腹腔鏡在胰腺真性囊腫切除術(shù)中的應(yīng)用 [J]. 中華醫(yī)學(xué)雜志, 2005; 85(3)∶164.
  5. 5. 　Warshaw AL. Conservation of the spleen with distal pancreatectomy [J]. Arch Surg， 1988; 123(5)∶550.
  6. 6. 　Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein [J]. Surgery， 1996; 120(5)∶885.
  7. 7. 　Kaneko H, Takagi S, Joubara N, et al. Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein [J]. J Hepatobiliary Pancreat Surg， 2004; 11(6)∶397.
  8. 8. 　Pierce RA, Spitler JA, Hawkins WG, et al. Outcomes analysis of laparoscopic resection of pancreatic neoplasms [J]. Surg Endosc， 2007; 21(4)∶579.
  9. 9. 　Pachter HL, Pennington R, Chassin J, et al. Simplified distal pancreatectomy with the Auto Suture stapler: preliminary clinical observations [J]. Surgery， 1979; 85(2)∶166.
  10. 10. 　Shimizu S, Tanaka M, Konomi H, et al. Laparoscopic pancreatic surgery: current indications and surgical results [J]. Surg Endosc， 2004; 18(3)∶402.
  11. 11. 　Ayav A, Bresler L, Brunaud L, et al. Laparoscopic approach for solitary insulinoma: a multicentre study [J]. Langenbecks Arch Surg， 2005; 390(2)∶134.
  12. 12. 　戴夢華, 趙玉沛, 廖泉， 等. 胰島素瘤腹腔鏡外科治療體會 [J]. 中華外科雜志, 2006; 44(3)∶165.
  13. 13. 　Gouya H, Vignaux O, Augui J, et al. CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas [J]. AJR Am J Roentgenol， 2003; 181(4)∶987.
  14. 14. 　Leksowski K. Thoracoscopic splanchnicectomy for control of intractable pain due to advanced pancreatic cancer [J]. Surg Endosc， 2001; 15(2)∶129.
  15. 15. 　Le Pimpec Barthes F, Chapuis O, Riquet M, et al. Thoracoscopic splanchnicectomy for control of intractable pain in pancreatic cancer [J]. Ann Thorac Surg， 1998; 65(3)∶810.
  16. 16. 　Takahashi T, Kakita A, Izumika H, et al. Thoracoscopic splanchnicectomy for the relief of intractable abdominal pain [J]. Surg Endosc， 1996; 10(1)∶65.
  17. 17. 　Worsey J, Ferson PF, Keenan RJ, et al. Thoracoscopic pancreatic denervation for pain control in irresectable pancreatic cancer [J]. Br J Surg， 1993; 80(8)∶1051.