Original Article
Comparison of the clinical application of three-dimensional and two-dimensional laparoscopic pancreaticoduodenectomy
Yong An, Yue Zhang, Shengyong Liu, Huihua Cai, Weibo Chen, Di Wu, Donglin Sun, Xuemin Chen
Published 2019-05-01
Cite as Chin J Surg, 2019, 57(5): 353-357. DOI: 10.3760/cma.j.issn.0529-5815.2019.05.007
Abstract
ObjectiveTo compare the clinical application of three-dimensional laparoscopic pancreatoduodenectomy (3D-LPD) with that of two-dimensional laparoscopic pancreatoduodenectomy (2D-LPD), and to explore the safety and feasibility of 3D-LPD.
MethodsA retrospective analysis was made from the data of 45 patients with 3D-LPD and 45 patients with 2D-LPD who underwent total laparoscopic pancreatoduodenectomy from March 2017 to August 2018 at Department of Hepato-Pancreato-Biliary Surgery, the First People′s Hospital of Changzhou.The differences of intraoperative conditions, postoperative complications and postoperative pathological findings between the two methods were compared.Measurement data were compared with independent sample t-test, enumeration data were statistically analyzed with Chi-square test or Fisher exact probability.
ResultsThe operation time of 3D-LPD group was shorter than that of 2D-LPD group ((335±95) min vs. (419±113) min, t=-3.817, P=0.000), which mainly showed that the time of digestive tract reconstruction was reduced ((92±26) min vs. (131±46) min, t=-4.951, P=0.000). The intraoperative blood loss in the 3D-LPD group was significantly less than that in the 2D-LPD group ((242±124) ml vs. (350±176) ml, t=-3.365, P=0.001), and the perioperative blood transfusion in the 3D-LPD group was significantly less than that in the 2D-LPD group (χ2=4.444, P=0.035). Postoperative hospitalization days and ICU stay time were not significantly different between the two groups(both P>0.05). Postoperative complications such as pancreatic fistula, biliary fistula, postoperative bleeding, gastric emptying disorders, abdominal infection, were not significantly different between the two groups(all P>0.05).
ConclusionsThe operation time of 3D-LPD is shorter than that of 2D-LPD, and the amount of bleeding is less. Short-term clinical data showed that, 3D-LPD is effective, safe and worth popularizing.
Key words:
Pancreatic neoplasms; Pancreaticoduodenectomy; Three-dimensional laparoscopic surgery; Two-dimensional laparoscopic surgery
Contributor Information
Yong An
Department of Hepato-Pancreato-Biliary Surgery, the First People′s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
Yue Zhang
Shengyong Liu
Huihua Cai
Weibo Chen
Di Wu
Donglin Sun
Xuemin Chen