Intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection for pancreatic head benign or low-grade malignant tumors
Purpose Laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt) is used for treating benign or low-grade malignant tumors of the pancreatic head. However, preservation of the duodenum and biliary tract integrity remains challenging. We present a new approach for LDPPHRt and evaluate its feasibility and safety. Methods From April 2020 to December 2020, 30 patients successfully underwent LDPPHRt using the intracapsular approach in our center. Their medical records were reviewed for relevant clinical characteristics, pathologic findings, postoperative complications, and survival. Results The median diameter of the lesions was 3.6 cm (range, 2.0-5.5 cm). The median operative time was 234.7 min (range, 195-310 min). The median blood loss was 66.7 ml (range, 20-250 ml). The morbidity rate was 26.7%, including POPF, hemorrhage, lymphatic leakage, wound infection, pulmonary infection, and delayed gastric emptying. Five patients developed pancreatic fistula type A, and two patients had type B, classified according to the International Study Group on Pancreatic Fistula. No biliary tract injury or duodenal leakage was observed. The median postoperative hospital stay was 11.5 days (range, 6-25), and the operative mortality rate was 0%. Conclusion The intracapsular approach is a feasible and safe surgical procedure in LDPPHRt for patients with benign or low-grade malignant tumors, especially those without severe pancreatic head fibrosis or peripancreatic adhesions.
基金:
National Natural Science Foundation of China [81772950, 82073249, 81773160, 81874205, 81702792]; Tongji Hospital Clinical Research Flagship Program [2019CR203]; Hubei Natural Science Foundation [2017CFB467, WJ2017Z010]; National Key Research and Development Program of China [2019TFC1315905]; Tongji Hospital Science Fund for Distinguished Young Scholars (2017)
第一作者单位:[1]Huazhong Univ Sci & Technol,Affiliated Tongji Hosp,Tongji Med Coll,Dept Biliary Pancreat Surg,Wuhan 430030,Hubei,Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Zhou Min,Xu Simiao,Chao Dang,et al.Intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection for pancreatic head benign or low-grade malignant tumors[J].LANGENBECKS ARCHIVES OF SURGERY.2022,407(8):3851-3858.doi:10.1007/s00423-022-02509-5.
APA:
Zhou, Min,Xu, Simiao,Chao, Dang,Wang, Min,Zhu, Feng...&Qin, Renyi.(2022).Intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection for pancreatic head benign or low-grade malignant tumors.LANGENBECKS ARCHIVES OF SURGERY,407,(8)
MLA:
Zhou, Min,et al."Intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection for pancreatic head benign or low-grade malignant tumors".LANGENBECKS ARCHIVES OF SURGERY 407..8(2022):3851-3858