中国实用外科杂志

中国实用外科杂志

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巨大腹膜后肿物切除联合胰十二指肠切除10例诊治分析

钱红纲，李成鹏，吴剑挥，丘    辉，郝纯毅   

  1. 恶性肿瘤发病机制及转化研究教育部重点实验室 北京大学肿瘤医院暨北京市肿瘤防治研究所软组织与腹膜后肿瘤中心，北京100142
  • 出版日期:2017-06-01 发布日期:2017-05-31

  • Online:2017-06-01 Published:2017-05-31

摘要：

目的    探讨巨大腹膜后肿物切除时联合胰十二脂肠切除是否显著增加手术风险。方法    回顾性分析2015年9月至2016年10月北京大学肿瘤医院软组织与腹膜后肿瘤中心行巨大腹膜后肿物切除联合胰十二指肠切除10例病人临床资料，总结其手术相关并发症及围手术期效果。结果    10例病人均顺利切除肿瘤。手术时长为360～1020 min，术中出血量 400～6000 mL，10例病人除联合胰十二指肠切除外，均联合了结肠的部分切除，6例联合了血管的切除和替代，5例联合右肾及右肾上腺的切除，5例行右侧膈肌的部分切除及修补，4例联合肝脏的切除。术后发生B级以上胰瘘2例，Clavien-Dindo Ⅲa级以上并发症2例，无围手术期死亡病例。结论    腹膜后巨大肿物切除联合胰十二指肠切除术并不显著增加手术风险，安全可行。

关键词: 腹膜后肿瘤, 胰十二指肠切除术, 手术安全性

Abstract:

Pancreaticduodenectomy for large retroperitoneal tumor resection：An analysis of 10 cases        QIAN Hong-gang，LI Cheng-peng，WU Jian-hui，et al. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education); Soft Tissue and Retroperitoneal Tumor Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
Corresponding author：HAO Chun-yi,E-mail：haochunyi@vip.sina.com
Abstract    Objective    To investigate the feasibilities and safeties of pancreaticduodenectomy for the surgical treatment of large retroperitoneal tumors. Methods    The clinical data of 10 consecutive cases of large retroperitoneal tumors performed pancreaticduodenectomy at Soft Tissue and Retroperitoneal Tumor Center of Peking University Cancer Hospital between September 2015 and October 2016 were analyzed retrospectively. Surgical complication and perioperative outcome were summarized. Results    All tumors were resected completely. Operations lasted for 360 to 1020 min. The blood loss was 400 to 6000mL. Pancreaticduodenectomy and partial colectomy were performed in all 10 patients， combined with 6 cases of large vessels resection and replacement， 5 cases of right nephrectomy and adrenalectomy，5 cases of diaphragm partial resection and repair，4 cases of hepatectomy. Two cases were observed with ISGPF Grade B pancreatic fistula and 2 cases with complication of Clavien-Dindo Ⅲa and V， respectively. No patient died of complications during perioperative period. Conclusion    Pancreaticduodenectomy is safe and feasible in resection of large retroperitoneal tumors.

Key words: retroperitoneal tumor, pancreaticduodectomy, safety of operation