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目的:探讨微创外科手术方式在治疗胰腺神经内分泌肿瘤中的可行性和安全性,了解其的适应证及可能优势。方法:回顾分析我院外科2006年8月至2013年9月微创手术治疗胰腺神经内分泌肿瘤21例资料,根据手术入路分为机器人手术组(n=13)和腹腔镜手术组(n=8),收集两组病人的围手术期资料。结果:机器人手术组包括胰岛素瘤8例,无功能性神经内分泌肿瘤5例;手术方式为胰十二指肠切除术4例,胰体尾切除术4例,胰腺中段切除2例,Beger手术1例,胰腺肿瘤局部剜除2例。腹腔镜手术组包括胰岛素瘤6例,无功能性神经内分泌肿瘤2例:手术方式为胰十二指肠切除术1例,胰体尾切除术7例。所有病人均顺利完成手术,无中转开腹,无围手术期死亡。随访至今,均无复发及其他并发症发生。结论:微创手术治疗胰腺神经内分泌肿瘤是安全、可行的,术后创伤小、恢复快。机器人手术在治疗胰腺神经内分泌肿瘤的方式上有更多的选择。
Objective: To investigate the feasibility and safety of minimally invasive surgery in the treatment of pancreatic neuroendocrine tumors and to find out its indications and possible advantages. Methods: The data of 21 cases of pancreatic neuroendocrine tumors treated by minimally invasive surgery from August 2006 to September 2013 in our hospital were retrospectively analyzed. According to the surgical approach, the patients were divided into two groups: robotic surgery group (n = 13) and laparoscopic surgery group (n = 8), collect the perioperative data of two groups of patients. Results: The robot operation group included 8 cases of insulinoma and 5 cases of non-functional neuroendocrine tumors. The operation mode was pancreaticoduodenectomy in 4 cases, pancreatectomy in 4 cases, pancreas in 2 cases, Beger operation in 1 Cases, partial removal of pancreatic cancer in 2 cases. Laparoscopic surgery group included 6 cases of insulinoma and 2 cases of non-functional neuroendocrine tumor. The operation mode was pancreatoduodenectomy in 1 case and pancreatectomy in 7 cases. All patients successfully completed the operation, no transit laparotomy, no perioperative deaths. Follow-up so far, no recurrence and other complications occurred. Conclusion: Minimally invasive surgery for pancreatic neuroendocrine tumors is safe and feasible, with less trauma and faster recovery. Robotic surgery has more options in the treatment of pancreatic neuroendocrine tumors.