Objective: To 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. Methods: A 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. Results: The 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 (χ(2)=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). Conclusions: The 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.
目的： 比较三维（3D）腹腔镜与二维（2D）腹腔镜胰十二指肠切除术（LPD）的临床应用效果。 方法： 回顾性分析2017年3月至2018年8月于常州市第一人民医院肝胆胰外科接受LPD的90例患者的资料，其中3D-LPD组45例，2D-LPD组45例。对比两组患者的术中情况、术后并发症及术后病理学指标的差异。计量资料的比较采用独立样本t检验、计数资料的比较采用χ(2)检验或Fisher确切概率法。 结果： 3D-LPD和2D-LPD组患者的基线资料具有可比性（P值均>0.05）。3D-LPD组与2D-LPD组手术时间的差异有统计学意义[（335±95）min比（419±113）min，t=-3.817，P=0.000]，3D-LPD组消化道重建的时间更短[（92±26）min比（131±46）min，t=-4.951，P=0.000]。3D-LPD组术中出血量明显少于2D-LPD手术组[（242±124）ml比（350±176）ml，t=-3.365，P=0.001]，3D-LPD组围手术期输血例数少于2D-LPD手术组（χ(2)=4.444，P=0.035）。两组术后住院天数、ICU监护时间的差异均无统计学意义（P值均>0.05）。两组术后并发症如胰瘘、胆瘘、术后出血、胃排空延长、腹腔感染的差异亦无统计学意义（P值均>0.05）。 结论： 3D-LPD比2D-LPD的手术时间短，出血量少，近期临床结果显示其安全、有效，值得进一步推广。.
Keywords: Pancreatic neoplasms; Pancreaticoduodenectomy; Three-dimensional laparoscopic surgery; Two-dimensional laparoscopic surgery.