ABSTRACT
Objective:To evaluate the safety and feasibility of laparoscopic radical anterograde modular pancreatosplenectomy (Lap-RAMPS).Methods:From Jan 2014 to Dec 2020, the clinical data of 83 patients who underwent laparoscopic radical resection for pancreatic tail cancer in LiHuili Hospital of Ningbo Medical Center were retrospectively analyzed.Results:Eighty-three cases were divided into Lap-RAMPS group (44 cases) and laparoscopic conventional distal pancreatectomy and splenectomy(Lap-CDP) group (39 cases). There were no significant differences in the duration of surgery [(245.34±70.30) min vs. (239.87±68.10) min], intraoperative blood lose [(159.32±115.60) ml vs. (208.97±161.70) ml] and intraoperative transfusions (2 cases vs. 3 cases) between the two groups ( P>0.05). There were no statistical significance in both groups in postoperative pancreatic fistula, postoperative bleeding grade, postoperative gastric emptying delay, Clavien-Dindo complication and postoperative hospital stay ( P>0.05). There were statistically significant differences in the negative margin rate (93.2% vs. 76.9%),lymph node harvest(12.91±8.24 vs. 8.49±6.85) and median survival time (25.0 months vs. 15.0 months) between the two groups ( P<0.05). Conclusion:Lap-RAMPS for pancreatic tail cancer is safe and feasible, increasing the negative rate of pancreatic margins, improving the lymph node harvest, and prolonging patients' survival time.
ABSTRACT
Objective@#To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy.@*Methods@#Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center, retrograde left hemihepatectomy was carried out in 31 patients, and antegrade left hemihepatectomy in 34 patients. The perioperative data, duration of operation, intraoperative blood loss, postoperative complications (including major bleeding, abdominal abscess and bile leakage), and post-operative hospital stay were retrospectively compared between the two groups.@*Results@#There were no significant differences in the perioperative general status between the two groups (P>0.05). Both the duration of operation [(121.5±22.1) min vs. (190.9±48.9) min, P<0.05] and the amount of blood loss [(118.9±84.1) ml vs. (195.2±85.4) ml, P<0.05] were significantly less in the retrograde than the antegrade group. There were no statistical differences in the incidences of major complications such as post-hepatectomy hemorrhage, abdominal abscess, or bile leakage, and in the postoperative hospital stay [(10.0±2.8) d vs. (12.2±3.4) d, P>0.05].@*Conclusions@#Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly. The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy.