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- 沈柏用主任医师 教授
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医院:
上海交通大学医学院附属瑞金医院
科室:
普外科
- Early experience for the robotic duodenum preserving pancreatic head resection
- 作者:沈柏用|发布时间:2012-07-20|浏览量:475次
Background: The duodenum preserving pancreatic head resection (DPPHR) has been accepted as a valid surgical alternative to more extensive standard resections for the treatment of benign and low malignant tumors at the head of pancreas. In this article, a new minimally invasive operation, the robot-assisted laparoscopic technique, has been introduced to this procedure.上海瑞金医院普外科沈柏用
Methods: From March 2010 to Dec 2010, 4 patients (3 females and 1 male), with a mean age of 42.3(21 ~ 62) years, underwent robot-assisted laparoscopic duodenum preserving pancreatic head resection at the Hepato-Bilio-Pancreatic Surgical Department of Ruijin Hospital in Shanghai, China. The preoperative symptom includes two cases of repeated upper abdominal pain, one case of no obvious preoperative symptom and one case of repeated hypoglycemia. The da Vinci Surgical System was used to perform the main steps of the operation. All patients underwent a pancreaticogastrostomy for pancreaticoenteric reconstruction to the distal stump.
Results: All 4 surgeries were successfully performed. There were no mortalities. The mean operation time is 298.8 (270 ~ 335) min, average blood loss is 425 (100 ~ 600) ml. The mean postoperative hospital stay was 26.8 (20 ~ 30) days. The patient with islet cell tumor has held a normal blood glucose levels after the surgery and the other 3 patients have had no hyperglycemia. Three patients developed a pancreatic fistula and cured later by the conservative treatment.
Conclusions: Robotic surgical system is technically fully capable of performing the complex operation of this procedure with an acceptable surgical complication range. It breaks through the bottleneck of the traditional laparoscopic technology and expands the range of its applications. However, this new technology is still under an exploratory stage and their long-term effect is very much needed to be confirmed by more clinical data in the future.