切换至 "中华医学电子期刊资源库"

中华腔镜外科杂志(电子版) ›› 2020, Vol. 13 ›› Issue (05) : 288 -290. doi: 10.3877/cma.j.issn.1674-6899.2020.05.008

所属专题: 机器人手术 经典病例 文献

病例报告

机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术
赵国栋1, 张修平1, 赵之明1, 高元兴1, 谭向龙1, 刘荣1,()   
  1. 1. 100853 北京,解放军总医院肝胆胰外科医学部
  • 收稿日期:2020-09-02 出版日期:2020-10-30
  • 通信作者: 刘荣

Robot-assisted in situ resection of intraductal papillary mucinous adenoma of pancreas combined with main pancreatic duct bridging

Guodong Zhao1, Xiuping Zhang1, Zhiming Zhao1, Yuanxing Gao1, Xianglong Tan1, Rong Liu1,()   

  1. 1. Faculty of Hepato-Biliary-Pancreatic Surgery, The First Medical Center of Chinese People′s Liberation Army (PLA) General Hospital, 100853 Beijing, China
  • Received:2020-09-02 Published:2020-10-30
  • Corresponding author: Rong Liu
  • About author:
    Corresponding author: Liu Rong, Email:
引用本文:

赵国栋, 张修平, 赵之明, 高元兴, 谭向龙, 刘荣. 机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术[J/OL]. 中华腔镜外科杂志(电子版), 2020, 13(05): 288-290.

Guodong Zhao, Xiuping Zhang, Zhiming Zhao, Yuanxing Gao, Xianglong Tan, Rong Liu. Robot-assisted in situ resection of intraductal papillary mucinous adenoma of pancreas combined with main pancreatic duct bridging[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2020, 13(05): 288-290.

目的

总结机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术的经验。

方法

回顾性分析2020年5月在解放军总医院肝胆胰外科医学部进行机器人下胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术患者的临床资料。

结果

患者顺利完成手术,镜下操作时间135 min,术中出血量约50 ml,术后6 d带引流管出院,术后18 d左右拔除引流管。术后病理考虑为导管内乳头状黏液腺瘤伴低级别上皮内瘤变。

结论

原位切除联合主胰管架桥修复术是一种新的手术方式和外科理念,在功能脏器保护的同时更注意生理解剖完整性的保护,通过主胰管架桥修复为核心技术的胰腺整形修复术还原人体正常解剖结构,显著提高患者生活质量。

Objective

To summarize the experience of robot assisted in situ resection of intraductal papillary mucinous adenoma of the pancreas combined with main pancreatic duct bridging.

Methods

The clinical data of patients who underwent in situ resection of pancreatic intraductal papillary mucinous adenoma combined with main pancreatic duct bridge repair in May 2020 in the Department of Hepatobiliary Pancreatic surgery, General Hospital of Chinese PLA were retrospectively analyzed.

Results

The patient successfully completed the operation. The operation time was 135 minutes under the microscope, and the blood loss was about 50 ml. the drainage tube was discharged 6 days after the operation, and the drainage tube was removed about 18 days after the operation. Intraductal papillary myxoma with low grade intraepithelial neoplasia was considered pathologically.

Conclusions

In situ resection combined with main pancreatic duct bridge repair is a new surgical method and surgical concept. While protecting the functional organs, more attention should be paid to the protection of physiological and anatomical integrity. Through the main pancreatic duct bridge repair as the core technology of pancreatic plastic repair, the normal anatomical structure of human body can be reduced, and the quality of life of patients can be significantly improved.

图1 患者围手术期影像学检查与对比
图2 机器人下分支胰管型胰腺导管内乳头状黏液腺瘤原位切除联合主胰管架桥修复术
1
Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al. Revisions of international consensus fukuoka guidelines for the management of ipmn of the pancreas[J]. Pancreatology,2017,17(5):738-753.
2
Elta GH, Enestvedt BK, Sauer BG, et al. Acg clinical guideline: diagnosis and management of pancreatic cysts[J]. Am J Gastroenterol,2018,113(4):464-479.
3
European Study Group on Cystic Tumours of the P. European evidence-based guidelines on pancreatic cystic neoplasms[J]. Gut,2018,67(5):789-804.
4
Yamada S, Fujii T, Shimoyama Y, et al. Clinical implication of morphological subtypes in management of intraductal papillary mucinous neoplasm[J]. Ann Surg Oncol ,2014,21(7):2444-2452.
5
Chen K, Pan Y, Zhang B, et al. Laparoscopic versus open pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis[J]. Int J Surg,2018,53:243-256. DOI:10.1016/j.ijsu.2017.12.032.
6
Min JH, Kim YK, Kim H, et al. Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines[J]. Abdom Radiol (NY) 2020.DOI:10.1007/s00261-020-02627-y.
7
Liu R, Wakabayashi G, Palanivelu C, et al. International consensus statement on robotic pancreatic surgery[J]. Hepatobiliary Surg Nutr,2019,8(4):345-360.
8
Zhao ZM, Jiang N, Gao YX, et al. Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: single-center experience with 82 patients[J]. World J Gastrointest Oncol,2020,12(6):642-650.
9
Wang ZZ, Zhao GD, Zhao ZM, et al. An end-to-end pancreatic anastomosis in robotic central pancreatectomy[J]. World J Surg Oncol,2019,17(1):67. DOI:10.1186/s12957-019-1609-5.
[1] 国际机器人乳腺外科手术专家协作组(专家委员会). 机器人乳腺癌手术专家共识[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(03): 129-139.
[2] 丁莹莹, 宋恺, 金姬延, 田华. 机器人辅助膝髋关节置换术后精细化临床护理[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 553-557.
[3] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[4] 潘韩丽, 何静, 陈媛媛, 贾梦瑶, 赵兴, 杨佩. 机器人辅助全髋关节置换围手术期应用加速康复护理[J/OL]. 中华关节外科杂志(电子版), 2024, 18(01): 142-146.
[5] 王振宁, 杨康, 王得晨, 邹敏, 归明彬, 王雅楠, 徐明. 机器人与腹腔镜手术联合经自然腔道取标本对中低位直肠癌患者远期疗效比较[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 437-442.
[6] 郭仁凯, 武慧铭, 李辉宇. 机器人辅助全系膜切除术治疗右半结肠癌有效性和安全性的Meta分析及试验序贯分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(03): 234-240.
[7] 嵇晋, 吴胜文, 姜明瑞, 汪刘华, 王伟, 任俊, 王道荣, 马从超. 三种方式关闭盆底联合改良造口在直肠癌腹会阴联合切除术的对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 406-410.
[8] 孙昭, 刘琪, 王殿琛, 姜建武, 符洋. 机器人对比腹腔镜及开放式腹股沟疝修补术的Meta 分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 588-598.
[9] 刘明昊, 李晨, 王冰, 万政, 田文. 机器人与腹腔镜食管裂孔疝修补术对比研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 376-382.
[10] 魏孔源, 仵正, 王铮, 黎韡. 机器人胰腺中段切除后远端胰腺消化道不同重建方式初探[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 295-300.
[11] 曾纪晓, 徐晓钢, 王欣星, 刘斐, 兰梦龙, 陶波圆, 梁子建, 叶志华, 罗媛圆. 达芬奇机器人辅助Swenson-like巨结肠根治术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(04): 239-243.
[12] 王楠, 李立安, 杨雯, 顾成磊, 叶明侠, 李卫平, 张晓莉, 陈琳, 朱晓明, 罗成, 樊杨, 魏淑会, 孟元光. 5G远程机器人妇科手术初步临床实践与评价[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 168-172.
[13] 张可欣, 孙大为, 任常. 国产单孔蛇形臂腹腔镜机器人在妇科领域的应用探索[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 106-110.
[14] 满艺, 李宝山, 王荫龙. 机器人腹股沟疝修补术的现状与进展[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(01): 62-64.
[15] 王佳琦, 李兴源, 熊寰, 常泽文, 王子桐, 燕国庆, 丁可, 袁子茗, 乔天宇, 黄睿, 王贵玉, 汤庆超. 机器人手术系统辅助下的结直肠癌经自然腔道取标本手术与常规辅助切口取标本手术的近期疗效对比研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(02): 121-128.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?