中国实用外科杂志

中国实用外科杂志

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应用机器人手术系统行肝胆胰手术单中心1000例报告

刘    荣，尹注增，赵之明，胡明根，高元兴，谭向龙，赵国栋，张    煊，李成刚   

  1. 中国人民解放军总医院 全军肝胆外科研究所 肝胆胰肿瘤外科，北京100853
  • 出版日期:2017-03-01 发布日期:2017-03-02

  • Online:2017-03-01 Published:2017-03-02

摘要：

目的    总结应用机器人手术系统行肝胆胰手术的临床经验。方法    回顾性分析中国人民解放军总医院肝胆胰肿瘤外科自2011年11月15日至2017年2月9日应用机器人手术系统行肝胆胰手术1000例病人的临床资料。结果    1000例病人中，中转开腹率4.6%，围手术期病死率0.3%，术后平均住院时间（9.7±7.9）d。其中肝脏手术260例，胰腺手术600例，胆道手术83例，其他手术57例。应用机器人手术系统行胰十二指肠切除术、左或右半肝切除术、胆囊癌根治术、肝门胆管癌根治术、胰腺中段切除及胰体尾切除术等复杂肝胆胰手术占65.9%。结论 机器人手术系统更适合于行复杂的肝胆胰切除和重建手术。不论开腹手术还是传统腹腔镜亦或机器人手术，三种手术方式不会相互取代，而是相辅相成，协同发展，最终的目的是实现病人利益的最大化。

关键词: 机器人手术系统, 肝胆胰外科

Abstract:

Hepato-pancreato-biliary surgeries using robotic surgical system in a single institute: One thousand cases                  LIU Rong, YIN Zhu-zeng, ZHAO Zhi-ming, et al. The Institute of Hepato-pancreato-biliary Surgery, Department of Hepato-pancreato-biliary Surgical Oncology, PLA Genral Hospital, Beijing 100853, China.
Corresponding author: LIU Rong, E-mail: liurong301@126.com
Abstract    Objective    To summarize the clinical experience of 1000 cases of hepato-pancreato-biliary surgeries using robotic surgical system. Methods    The clinical results of a consecutive series of patients who underwent robotic hepato-pancreato-biliary operations between Nov 15, 2016 and Feb 9 2017 were reviewed. Results    A total of 1000 robotic assisted operations were performed, including 260 case of robotic assisted hepatectomy, 600 case of robotic assisted pancreatectomy, 83 case of robotic assisted biliary surgery and 57 case of other robotic assisted operations. The convert rate, mortality rate and postoperative hospital stay was 4.6%, 0.3% and 9.71±7.93d respectively. Additionally, complicated hepato-pancreato-biliary operations accounted for 65.9%, including robotic assisted hemihepatectomy, robotic assisted distal pancreatectomy, robotic assisted segmental pancreatectomy, robotic assisted pancreaticoduodenectomy, robotic assisted radical resection of gallbladder cancer, and robotic assisted radical resection for hilar cholangiocarcinoma. Conclusions    The robotic operative system appears to be more suitable for complex procedures involving hepato-pancreato-biliary resection and reconstruction. None of robotic assisted laparoscopic, traditional laparoscopic or open approach can replace others, and the exact surgical approach for a patient should be chosen carefully to maximize the clinical benefits.