Clinical Analysis Of Low-invasive Surgery For Benign Lesions Of Pancreatic Head

Objective:To explore the safety of low-invasive surgery in the treatment of benign pancreatic head lesions.Methods:To analyze retrospectively the clinical data of 87 patients with benign pancreatic head lesions treated in general surgery department of the Second Hospital of Shanxi Medical University from December 2003 to June 2018.There were 27 cases of mucinous cystic neoplasms(MCNs),21 cases of serous cystic neoplasms(SCNs),6 cases of intraductal papillary mucinous neoplasms(IPMNs),18 cases of chronic pancreatitis,12 cases of insulinoma and 3 cases of gastrinoma.Pancreatoduodenectomy(PD)was performed in24 cases,duodenum-preserving pancreatic head resection(DPPHR)in 39 cases,and enucleation(EN)in 24 cases.Results:There were 5 cases(20.8%)of grade A pancreatic leakage in EN,1 case(4.2%)of grade B/C pancreatic leakage,4 cases(10.3%)of grade A pancreatic leakage in DPPHR and 2 cases(5.1%)of grade B/C pancreatic leakage.There were 3 cases of grade A pancreatic leakage(12.5%)and 2 cases of grade B/C pancreatic leakage(8.3%)in PD operation,and there was no significant difference among the three groups(P > 0.5).In DPPHR group,there were 3 cases of gastric emptying dysfunction(7.7%),2 cases of diarrhea(5.1%),3 cases of abdominal cavity infection(7.7%)and 1 case of new diabetes(2.6%);in PD group,there were 3 cases of gastric emptying dysfunction(12.5%),2 cases of diarrhea(8.3%),2 cases of abdominal cavity infection(8.3%)and 2 cases of new diabetes(8.3%).There was no significant difference between the two groups(P > 0.5).87 patients were followed up and no recurrence of the original disease was found during the follow-up period.Conclusion:For benign lesions of the head of pancreas,it is safe and feasible to perform minimally invasive surgery to reduce tissue and organ excision according to the size of the lesion and the relationship between the size of the lesion and the structure of the surrounding ducts.