| Pancreatic cancer and periampullary carcinoma develop rapidly.They are malignant tumors of digestive tract with poor therapeutic effect and poor prognosis.Periampullary carcinoma includes carcinoma of ampulla,lower part of common bile duct and carcinoma of duodenum.Pancreaticoduodenectomy is a standard surgical treatment for patients without surgical taboo and metastasis.The surgical resection covers the head of the pancreas(including the uncinate process),distal stomach,duodenum,upper jejunum,gallbladder and common bile duct,and the lymph nodes of the region need to be removed at the same time.Theoperation is difficult,the postoperative complications are many,and it is a great blow to the patient.With the rapid development of laparoscopic technique,laparoscopic pancreaticoduodenectomy(LPD)As a kind of minimallyinvasive operation,it has been carried out graduallyin somelarge medical centers,but the feasibility and safety of the operationhave been controversial all the time,and the clinical effects reported at homeand abroad are not always the same.In this study,theclinical effects of laparoscopic pancreatoduodenectomy(LPD)and traditional open pancreaticoduodenectomy(OPD)were compared to explore he clinical Efficacy of LPD in order to make a decision on the best treatment method forthis kind of patients.Objective:The clinical effects of laparoscopic pancreatoduodenectomy(LPD)and open pancreaticoduodenectomy(OPD)were compared to discus thefeasibility and safety of LPD.Methods:Retrospective analysis of 21 cases of laparoscopic pancreaticoduodenectomy(LPD)and 20 cases of open pancreaticoduodenectomy from January 2015 to August 2018 in our department(hepatobiliary and acute abdomen surgery)Perioperative data of patients undergoing finger resection(OPD),comparing the surgical procedures,postoperative recovery and other related perioperative conditions in the two groups.Results:The operation time of LPD group and OPD group were(317.14 ±44.06)min and(306.00 ±44.18)min,(523.91 ±261.54)ml and(615.03 ±377.47)ml,respectively.There was no significant difference in intensivecare time between).LPD group and OPD group(9.32 ±2.11)days and(7.34 ±3.51)days,and the time of biliary and intestinal drainage was(8.61 ±2.83)days and(12.42 ±3.82)days respectively.The hospitalization cost was(9.31 ±1.81 million yuan)and(6.92 ±1.03 million yuan),and the length of hospitalization was(27.41 ±5.82)days and(33.71 ±7.74)days.The difference was statistically significant between).LPD groupand OPD group(P < 0.05).The feeding time was(7.01 ±1.56)d and(8.22 ±2.71)d after operation,and the times of using analgesic drugs were(2.73 ±6.04)times and(4.91 ±5.62)days,respectively.The time of removing the catheter was(3.31 ±2.03)d and(3.04 ±1.82)d,and the time of removing the gastric tube was(5.54 ±1.15 days,(6.02 ±1.72)days,(14.63 ±4.23)days and(16.72 ±4.73)days,the number of removed lymph nodes was(7.24 ±4.81)and(4.42 ±7.76)days,and the time of removal of pancreatic and intestinal drainage tubes was(14.63 ±4.23)days and(16.72 ±4.73)days,respectively.There was no significant difference between the two groups(p > 0.05).There was no significant difference in postoperative complications between the two groups(p > 0.05).Results:LPD can achieve the same effect as OPD in terms of bleeding volume,radical cure degree,postoperative complications and so on.However,in terms of hospital stay and postoperative recovery,LPD is superior to OPD,in clinical efficacy. |
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