机器人辅助胰胆管结切除术在十二指肠良性肿瘤中的应用。

IF 1.2 4区 综合性期刊 Q3 MULTIDISCIPLINARY SCIENCES
Zejin Lin, Zeyu Lin, Taijun Yi, Yongling Liang, Chengrui Zhong, Ziyan Mai, Jiayan Wu, Zhiping Chen, Zhu Lin, Huilin Jin, Jiandong Yu, Yunle Wan, Guolin Li
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引用次数: 0

摘要

机器人辅助胰胆管结切除术是一种用于治疗良性十二指肠肿瘤的手术技术。这个过程包括几个关键步骤:一期在十二指肠纵向切开,胰胆交界处切除肿瘤,置入胆道支架,连接胆道和十二指肠粘膜,缝合十二指肠切口。机器人系统提高了可视性,便于精确操作,最大限度地减少了十二指肠牵引对十二指肠的损伤和手术创伤,保证了胆管支架的准确缝合和固定。连接胆管和十二指肠黏膜,缩短术后恢复时间。鉴于手术的复杂性和术后十二指肠瘘的相关风险,全面的术前评估和细致的围手术期准备是至关重要的。在手术之前,进行了全面的评估,包括患者的病史、家族史、血清学检查和影像学检查。特别强调确定肿瘤的良恶性,评估十二指肠动脉供血网络的状况,以确定手术的可行性和有效性。术中尽量减少十二指肠损伤,避免损伤十二指肠动脉供血网络。此外,胆管支架的使用被认为是必要的,以防止胆道狭窄,促进胆汁排出,并减轻胆道并发症。术后实时监测引流液中淀粉酶和黄疸指标,根据术后增强恢复(ERAS)方案及时拔除引流管。随后的随访表明恢复成功,其特点是术前腹痛明显减轻,无长期并发症,无肿瘤复发的迹象。因此,机器人辅助胰胆管结切除术是一种安全有效的治疗良性十二指肠肿瘤的手术方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application of Robot-assisted Pancreaticobiliary Junction Resection in Benign Duodenal Tumors.

Robot-assisted pancreaticobiliary junction resection is a surgical technique employed to treat benign duodenal tumors. The procedure involves several key steps: making a longitudinal incision in the duodenum, excising the tumor at the pancreaticobiliary junction, inserting a biliary stent, connecting the biliary and duodenal mucosa, and suturing the duodenal incision during phase I. The robotic system enhances visibility, facilitates precise operations, minimizes duodenal traction injuries to the duodenum and surgical trauma, ensures accurate suture and fixation of bile duct stents, connects the bile duct and duodenal mucosa and reduces postoperative recovery time. Given the complexity of the operation and the associated risk of postoperative duodenal fistula, a thorough preoperative evaluation and meticulous perioperative preparation are crucial. Prior to the procedure, a comprehensive assessment was conducted, integrating the patient's medical history, family history, serological tests, and imaging studies. Special emphasis was placed on determining the benign or malignant nature of the tumor and evaluating the status of the duodenal artery blood supply network to ascertain the feasibility and efficacy of the surgery. During the operation, efforts were made to minimize duodenal trauma and avoid compromising the duodenal artery blood supply network. Additionally, the use of bile duct stents was considered essential to prevent biliary strictures, facilitate bile discharge, and mitigate biliary complications. Postoperatively, real-time monitoring of amylase and jaundice indicators in drainage fluid informed the timely removal of drainage tubes in accordance with the enhanced recovery after surgery (ERAS) protocol. Subsequent follow-up indicated a successful recovery, characterized by a notable reduction in preoperative abdominal pain, the absence of long-term complications, and no evidence of tumor recurrence. Consequently, robot-assisted pancreaticobiliary junction resection demonstrates a safe and effective surgical approach for the treatment of benign duodenal tumors.

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来源期刊
Jove-Journal of Visualized Experiments
Jove-Journal of Visualized Experiments MULTIDISCIPLINARY SCIENCES-
CiteScore
2.10
自引率
0.00%
发文量
992
期刊介绍: JoVE, the Journal of Visualized Experiments, is the world''s first peer reviewed scientific video journal. Established in 2006, JoVE is devoted to publishing scientific research in a visual format to help researchers overcome two of the biggest challenges facing the scientific research community today; poor reproducibility and the time and labor intensive nature of learning new experimental techniques.
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