Laparoscopic transduodenal papillectomy with 3 cases
Objective Papillectomy can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy.However, the laparoscopic transduodenal papillectomy (LTDP) has rarely been attempted.Materials and Methods From Sep 2010 to Dec 2012, LTDP were performed in three patients and one of them was underwent transumbilical single-incision LTDP (case C).The mean size of mass was 2.5cm (2.0-3.0cm).In the operation, after locating the tumor, we performed a longitudinal duodenotomy of approximately 1.0 cm first, which was a little lower on the duodenum opposite the tumor and then lengthen it up or/and down to about 3.0-4.0cm just like a longitudinal dreich ” ∫ ” shape.The reconstruction was also performed with incision at the same time in total laparoscopic technique.Results LTDP was successful in the three patients.The mean operative time was 275 minutes (195-330min) and mean estimated blood loss was 240ml (l00-400ml).Postoperative histology of case A and C was the same as adenoma while case B with moderately differentiated adenocarcinoma with mucus cell cancer.The complications happened only in one with mild pancreatitis and biliary fistula, which were cured after conservative management.Recurrences were only seen in case B six months after operation.Conclusions Tranumbilical single-incision and four-port laparoscpoic transduodenal papillectomy were feasible and could be accomplished safely.
Jun Xu Lei Zhao Yinghui Guan Chunfu Liu
Department of General Surgery, Fourth Hospital of Harbin Medical University
国内会议
第六届中国武汉国际微创外科学术研讨会暨第五届中国药师协会微创外科医师学术交流会暨湖北省腹腔镜外科年会
武汉
英文
235-240
2013-10-11（万方平台首次上网日期，不代表论文的发表时间）