中国实用外科杂志2025，Vol.45Issue(2)：187-194,8.DOI:10.19538/j.cjps.issn1005-2208.2025.02.11
单孔+1与传统腹腔镜胰十二指肠切除术安全性与实用性对比研究
A comparative study of the safety and practicality of single incision plus one versus conventional laparoscopic pancreaticoduodenectomy
摘要
Abstract
Objective To report the surgical experience of single-incision plus one port laparoscopic pancreaticoduodenectomy(SILPD+1)and to compare its safety and practicality with that of conventional five-port laparoscopic pancreaticoduodenectomy(CLPD).Methods The clinical data of 49 patients who underwent LPD at the Department of Hepatobiliary and Pancreatic Surgery,Nanfang Hospital,Southern Medical University,between February 2023 and April 2024 were retrospectively analyzed,among which 14 patients underwent SILPD+1 and 35 patients underwent CLPD.Results There was no statistically significant differences in the baseline data of the patients in the two groups(P＞0.05)and the rate of conversion to open surgery(x2=0.006,P=0.941).Subsequently,the intraoperative and postoperative data of open cases were no longer included,and further statistical analysis was carried out on 12 cases of SILPD+1 and 32 cases of CLPD.Compared with the CLPD group,patients in the SILPD+1 group had intraoperative blood loss[150.0(100.0,287.5)mL vs.65.0(50.0,137.5)mL,Z=-2.862,P=0.004]and postoperative hospital stay length[15.7(11.9,21.1)d vs.11.2(10.0,14.9)d,Z=-2.109,P=0.035]were less,with lower postoperative pain scores[day 3:4.0(3.3,5.0)points vs.3.0(2.0,3.0)points,Z=-2.715,P=0.007;day 5:3.0(2.0,4.0)d vs.2.0(1.0,3.0)d,Z=-2.150,P=0.032].The quality of recovery scores were higher[day 3:63.0(58.0,68.8)points vs.72.5(68.3,75.8)points,Z=-3.536,P＜0.001;day 5:88.0(81.3,95.0)points vs.98.5(93.0,107.3)points,Z=-3.364,P=0.001],and the satisfaction with incision was higher(x2=4.805,P=0.028),and these differences were statistically significant.There was no statistically significant differences between the two groups in terms of the length of surgery,intraoperative accidental injury of important blood vessels,activities away from the bed,anal exsufflation,complication rate,and surgeon fatigue score(P＞0.05).Conclusion For experienced pancreatic surgeons,SILPD+1 is safe and feasible,with advantages in accelerating perioperative recovery,pain control,and quality of recovery enhancement,without significantly increasing operator fatigue.关键词
胰十二指肠切除术/单孔+1孔/腹腔镜手术/近期疗效Key words
laparoscopic pancreaticoduodenectomy/single-incision plus one port/laparoscopic surgery/recent efficacy分类
医药卫生引用本文复制引用
杨陈凤麟,李尧,陈品初,李芷西,丁洁茹,卫姝冰,张潇,张起帆..单孔+1与传统腹腔镜胰十二指肠切除术安全性与实用性对比研究[J].中国实用外科杂志,2025,45(2):187-194,8.基金项目
国家自然科学基金面上项目(No.82170647) （No.82170647）
广东省自然科学基金面上项目(No.2021A151511015) General Program of National Natural Science Foundation of China(No.82170647) （No.2021A151511015）
General Program of Natural Science Foundation of Guangdong Province(No.2021A151511015) （No.2021A151511015）
