腹腔镜胰腺切除术的解剖基础及临床应用研究
|
摘要
目的:目前腹腔镜技术已被广泛应用于外科的各个领域,但在胰腺外科中的发展一直比较缓慢,腹腔镜胰腺切除仍被认为是一项技术复杂的高风险手术。本课题的目的包括:①通过研究胰腺的腹腔镜下解剖特点,设计出针对不同位置病灶的手术入路;②通过总结腹腔镜胰腺切除术的临床经验,探讨该手术的技术要点和并发症防治措施;③通过与开腹手术的回顾性对比研究,探讨胰岛素瘤的诊治方法及腹腔镜胰岛素瘤切除的应用价值。
方法:①选取9例体型中等、拟行腹腔镜胰腺手术的病例,进行经腹腹腔镜胰腺探查,观察腹腔镜下胰腺的解剖结构和毗邻关系,寻找影响手术进程的重要解剖标志;分析5例后腹膜腹腔镜左肾切除术的手术录像,自后腹膜观察胰腺的解剖结构及毗邻关系;针对不同位置的病灶设计相应的手术入路。②应用设计的手术入路施行腹腔镜胰腺手术47例,其中男性17例,女性30例;术前诊断包括胰岛素瘤33例,胰腺囊腺瘤3例,胰腺囊腺癌1例,胰腺假性囊肿2例(其中1例合并左肝囊性占位),真性囊肿3例,无功能胰岛细胞瘤4例,实性假乳头状瘤1例。③回顾1993年1月至2008年12月在我院行手术治疗的胰岛素瘤89例,对腹腔镜组和开腹组的各项临床指标进行统计学分析。
结果:①按照川页序探查胰头、胰体尾,均于腹腔镜下成功观察到肠系膜上静脉、胃十二指肠动脉、胰腺钩突等重要的解剖结构。于后腹膜腹腔镜左肾根治性切除的录像中,成功观察到胰腺及其毗邻结构。针对不同的病变位置和手术方式,成功设计出前、后、左、右四条入路。②2003年3月至2009年2月,应用设计的手术入路施行腹腔镜胰腺手术47例,其中37例按原计划于全腹腔镜下完成手术,(37/47),另有8例中转开腹完成手术,2例未找到病灶终止手术。手术总体成功率95.7%(45/47),腹腔镜手术成功率78.7%,手术中转率17.0%(8/47)。平均手术时间240±140.8(90～960)ml,出血量184.0±310.5(20～1500)ml。术后并发症包括:术后出血2例,引流管脱出1例,胰瘘(C级)4例(1例合并胆漏),均经保守治疗愈合。③符合标准的83例胰岛素瘤患者中,腹腔镜组与在一般情况、手术成功率、手术时间、出血量、并发症发生率等指标方面与开腹组对比无显著性差异;但在术后恢复、体温变化指标等方面优于开腹组。
结论:①腹腔镜下可以寻找到胰腺的重要解剖标志,结合开腹胰腺应用解剖及术前影像学检查资料可以成功设计正确的手术入路和方案,从而提高腹腔镜胰腺手术的成功率和安全性。②应用我们设计的手术入路和技术方法,可以完成胰十二指肠切除、胰体尾切除等高难度手术,降低技术难度和手术并发症。在严格把握手术适应证的前提下,腹腔镜胰腺切除是一种治疗胰腺良性疾病和部分恶性疾病安全有效的方法。③与开腹手术相比,腹腔镜胰岛素瘤切除具有相同的疗效,同时具有创伤小、恢复快等优点,值得在临床上进一步推广。
Objective:
In recent years,laparoscopy has been widely used in many areas of surgery, however,laparoscopic pancreatic resection is still regarded as a complicated and high-risk operation.This study focused on the following objects:
1.Based on the observation of the laparoscopic pancreatic anatomy,this study aimed to design the optimal approaches for laparoscopic pancreatic surgery according to the lesions with different localization.
2.Through summarizing the experiences of laparoscopic pancreatic resection,this study aimed to discuss the key techniques and the prevention of complications for laparoscopic pancreatic resection.
3.To discuss the diagnosis and treatment of insulinoma and to evaluate the efficacy and safety of laparoscopic insulinoma resections through a retrospectively comparing study with the laparotomic procedure.
Methods:
1.9 patients with normal body mass index were enrolled into the study which proposed to laparoscopic pancreatic surgery.During the laparoscopic operations, the whole pancreas were explored and the pancreatic anatomic structure and adjacent relationship were detected.And some important anatomic signs which play important roles in the pancreatic resections were tried to be identified. Furthermore,5 videos of laparoscopic left nephrectomy through posterior peritoneum were analyzed,and the pancreatic anatomic structure and adjacent relationship were observed through the posterior peritoneum.Finally,according to the above research,we tried to design the eligible laparoscopic approaches for the lesions with different localization in the pancreas.
2.Then,with utilizing the designed laparoscopic approaches,47 cases,17 males and 30 females,underwent laparoscopic pancreatic resections in our hospital. Preoperative diagnosis included 33 cases of insulinoma,3 cases of pancreatic cystadenoma,1 case of pancreatic cystadenocarcinoma,2 cases of pseudocyst(1 case combined with hepatic cystic lesion),3 cases of true cyst,4 cases of nonfunctional islet cell tumor and 1 case of solid pseudo-papillary neoplasm.
3.The medical records of 89 patients with insulinomas which underwent surgical treatment during Jan 1993 to Dec 2008 in our hospital were analyzed retrospectively,and the related index were compared between the laparoscopic and laparotomic groups.
Results:
1.The whole pancreas could be explored successfully under laparoscopy,some important anatomic structures of pancreas,such as the superior mesenteric vein,the gastroduodenal artery and the uncinate process of pancreas,could be identified successfully.From the videos of laparoscopic left nephrectomy through posterior peritoneum,the pancreas tail and adjacent structure also could be observed clearly. And according to the different localization and surgical plan,4 corresponding laparoscopic approaches were designed.
2.During Mar 2003 to Feb 2009,47 cases of laparoscopic pancreatic resections were completed with the application of the designed laparoscopic approaches.The operations were successfully completed in 45 cases,the procedures included 37 cases of total laparoscopic resections and 8 cases of converting to open resections. We failed in the other 2 cases because the pancreatic lesions could not be identified during the operation.The success rate of the whole operations was 95.7%(45/47 ), for laparoscopic approach was 78.7%(37/47),the conversion rate was 17.0% (8/47 ).The mean operative time was 240±140.8 min(range:90-960 ),the mean blood loss was 184.0±310.5 ml(range:20-1500 ).Severe complications occurred in 7 cases postoperatively,including 2 cases of bleeding,1 case of drainage tube prolapse accidently and 4 cases of type C pancreatic fistula(1 case combined with biliary leak).All of these complications were healed by conservative treatments.
3.There was no significant differences in success rate,operation time,blood loss, complication rate between the laparoscopic and open groups.And the laparoscopic group seemed to have less invasion and taster recovery than the open approach.
Conclusions:
1.According to the pancreatic anatomy and the preoperative image,the optimal laparoscopic approaches could be designed successfully.Through those laparoscopic approaches,laparoscopic pancreatic resection could be completed smoothly.
2.Utilizing designed laparoscopic approaches,we could complete some difficult pancreatic resection,such as pancreaticoduodenectomy and distal pancreatectomy, and the technique of laparoscopic pancreatic resection could be simplified.This study suggests that,with selected patients,laparoscopic pancreatic resection is feasible and sate for the patients with presumed benign lesions and some early malignancies of pancreas.
3.Laparoscopic insulinoma resection has the same clinic efficacy as open approach, and it has less invasion and faster recovery.So it is worthwhile to be further extended in clinic.
方法:①选取9例体型中等、拟行腹腔镜胰腺手术的病例,进行经腹腹腔镜胰腺探查,观察腹腔镜下胰腺的解剖结构和毗邻关系,寻找影响手术进程的重要解剖标志;分析5例后腹膜腹腔镜左肾切除术的手术录像,自后腹膜观察胰腺的解剖结构及毗邻关系;针对不同位置的病灶设计相应的手术入路。②应用设计的手术入路施行腹腔镜胰腺手术47例,其中男性17例,女性30例;术前诊断包括胰岛素瘤33例,胰腺囊腺瘤3例,胰腺囊腺癌1例,胰腺假性囊肿2例(其中1例合并左肝囊性占位),真性囊肿3例,无功能胰岛细胞瘤4例,实性假乳头状瘤1例。③回顾1993年1月至2008年12月在我院行手术治疗的胰岛素瘤89例,对腹腔镜组和开腹组的各项临床指标进行统计学分析。
结果:①按照川页序探查胰头、胰体尾,均于腹腔镜下成功观察到肠系膜上静脉、胃十二指肠动脉、胰腺钩突等重要的解剖结构。于后腹膜腹腔镜左肾根治性切除的录像中,成功观察到胰腺及其毗邻结构。针对不同的病变位置和手术方式,成功设计出前、后、左、右四条入路。②2003年3月至2009年2月,应用设计的手术入路施行腹腔镜胰腺手术47例,其中37例按原计划于全腹腔镜下完成手术,(37/47),另有8例中转开腹完成手术,2例未找到病灶终止手术。手术总体成功率95.7%(45/47),腹腔镜手术成功率78.7%,手术中转率17.0%(8/47)。平均手术时间240±140.8(90～960)ml,出血量184.0±310.5(20～1500)ml。术后并发症包括:术后出血2例,引流管脱出1例,胰瘘(C级)4例(1例合并胆漏),均经保守治疗愈合。③符合标准的83例胰岛素瘤患者中,腹腔镜组与在一般情况、手术成功率、手术时间、出血量、并发症发生率等指标方面与开腹组对比无显著性差异;但在术后恢复、体温变化指标等方面优于开腹组。
结论:①腹腔镜下可以寻找到胰腺的重要解剖标志,结合开腹胰腺应用解剖及术前影像学检查资料可以成功设计正确的手术入路和方案,从而提高腹腔镜胰腺手术的成功率和安全性。②应用我们设计的手术入路和技术方法,可以完成胰十二指肠切除、胰体尾切除等高难度手术,降低技术难度和手术并发症。在严格把握手术适应证的前提下,腹腔镜胰腺切除是一种治疗胰腺良性疾病和部分恶性疾病安全有效的方法。③与开腹手术相比,腹腔镜胰岛素瘤切除具有相同的疗效,同时具有创伤小、恢复快等优点,值得在临床上进一步推广。
Objective:
In recent years,laparoscopy has been widely used in many areas of surgery, however,laparoscopic pancreatic resection is still regarded as a complicated and high-risk operation.This study focused on the following objects:
1.Based on the observation of the laparoscopic pancreatic anatomy,this study aimed to design the optimal approaches for laparoscopic pancreatic surgery according to the lesions with different localization.
2.Through summarizing the experiences of laparoscopic pancreatic resection,this study aimed to discuss the key techniques and the prevention of complications for laparoscopic pancreatic resection.
3.To discuss the diagnosis and treatment of insulinoma and to evaluate the efficacy and safety of laparoscopic insulinoma resections through a retrospectively comparing study with the laparotomic procedure.
Methods:
1.9 patients with normal body mass index were enrolled into the study which proposed to laparoscopic pancreatic surgery.During the laparoscopic operations, the whole pancreas were explored and the pancreatic anatomic structure and adjacent relationship were detected.And some important anatomic signs which play important roles in the pancreatic resections were tried to be identified. Furthermore,5 videos of laparoscopic left nephrectomy through posterior peritoneum were analyzed,and the pancreatic anatomic structure and adjacent relationship were observed through the posterior peritoneum.Finally,according to the above research,we tried to design the eligible laparoscopic approaches for the lesions with different localization in the pancreas.
2.Then,with utilizing the designed laparoscopic approaches,47 cases,17 males and 30 females,underwent laparoscopic pancreatic resections in our hospital. Preoperative diagnosis included 33 cases of insulinoma,3 cases of pancreatic cystadenoma,1 case of pancreatic cystadenocarcinoma,2 cases of pseudocyst(1 case combined with hepatic cystic lesion),3 cases of true cyst,4 cases of nonfunctional islet cell tumor and 1 case of solid pseudo-papillary neoplasm.
3.The medical records of 89 patients with insulinomas which underwent surgical treatment during Jan 1993 to Dec 2008 in our hospital were analyzed retrospectively,and the related index were compared between the laparoscopic and laparotomic groups.
Results:
1.The whole pancreas could be explored successfully under laparoscopy,some important anatomic structures of pancreas,such as the superior mesenteric vein,the gastroduodenal artery and the uncinate process of pancreas,could be identified successfully.From the videos of laparoscopic left nephrectomy through posterior peritoneum,the pancreas tail and adjacent structure also could be observed clearly. And according to the different localization and surgical plan,4 corresponding laparoscopic approaches were designed.
2.During Mar 2003 to Feb 2009,47 cases of laparoscopic pancreatic resections were completed with the application of the designed laparoscopic approaches.The operations were successfully completed in 45 cases,the procedures included 37 cases of total laparoscopic resections and 8 cases of converting to open resections. We failed in the other 2 cases because the pancreatic lesions could not be identified during the operation.The success rate of the whole operations was 95.7%(45/47 ), for laparoscopic approach was 78.7%(37/47),the conversion rate was 17.0% (8/47 ).The mean operative time was 240±140.8 min(range:90-960 ),the mean blood loss was 184.0±310.5 ml(range:20-1500 ).Severe complications occurred in 7 cases postoperatively,including 2 cases of bleeding,1 case of drainage tube prolapse accidently and 4 cases of type C pancreatic fistula(1 case combined with biliary leak).All of these complications were healed by conservative treatments.
3.There was no significant differences in success rate,operation time,blood loss, complication rate between the laparoscopic and open groups.And the laparoscopic group seemed to have less invasion and taster recovery than the open approach.
Conclusions:
1.According to the pancreatic anatomy and the preoperative image,the optimal laparoscopic approaches could be designed successfully.Through those laparoscopic approaches,laparoscopic pancreatic resection could be completed smoothly.
2.Utilizing designed laparoscopic approaches,we could complete some difficult pancreatic resection,such as pancreaticoduodenectomy and distal pancreatectomy, and the technique of laparoscopic pancreatic resection could be simplified.This study suggests that,with selected patients,laparoscopic pancreatic resection is feasible and sate for the patients with presumed benign lesions and some early malignancies of pancreas.
3.Laparoscopic insulinoma resection has the same clinic efficacy as open approach, and it has less invasion and faster recovery.So it is worthwhile to be further extended in clinic.
引文
].黄志强.外科微创化:21世纪外科的趋向.解放军医学杂志,2002;27(2):95-97
2.Gagner M,Pomp A.Laparoscopic pylorus-preserving pancreatoduodenectomy[J].Surg Endosc,1994,8(5):408-410
3.Cuschieri A,Jakimowicz J J,van Spreeuwel J.Laparoscopic distal 70%pancreatectomy and splenectomy for chronic pancreatitis.Ann Surg 1996,223:280-285.
4.Tagaya N,Kasama K,Suzuki N,et al.Laparoscopic resection of the pancreas and review of the literature.Surg Endosc,2003,17:201 -206.
5.Pierce RA,Spitler JA,Hawkins WG,et al.Outcomes analysis of laparoscopic resection of pancreatic neoplasms.Surg Endosc,2007,21:579-586
6.叶建宇,周汉新,彭毅等.腹腔镜腆体尾(保脾)切除术.中国微创外科杂志,2001(11):262-265.
7.王港,修典荣,马朝来.腹腔镜胰腺远端切除术26例.中国微创外科杂志,2009,9(1):5-7.
8.牟一平,陈其龙.腹腔镜胰体尾切除术的手术经验.肝胆外科,2008,16(3):168-170.
9.刘兴国.腹腔镜胰腺外科的应用解剖学及临床研究.第一军医大学级博士学位论文2004:4-9
10.王健本.胰.见裘法祖,王健本,张枯曾主编,腹部外科临床解剖学.济南山东科学技术出版社,200l第1版:225-248
11.孙庆峰,帏德恩,李玉兰,等.胰头十二指肠区域血管的应用解剖学研究哈尔滨医科大学学报,2003,37(5):409-411
12.姜树学.腹部.见姜树学.马述盛主编.断面解剖与CT、MRI、ECT对比图集.沈阳,辽宁科学技术出版社,2006年,第1版:185-188
13.邱实.腹部.见邱实主编.临床实用断层影像解剖学.郑州,河南医科大学出版社,2001年第1版:247-248。
14.印慨,胡明根,郑成竹等。腹腔镜胃腔内胃手术1例。中国实用外科杂志, 2004,24(2):118
15.印慨,郑成竹,邹晓平,孙振兴,胡明根,胡兵,李兆申。腹腔镜手术的新概念--腹腔镜胃腔内手术。中华胃肠外科杂志,2004,7(3):181-182
1 Dulucq JL,Wintringer P,Mahajna A.Laparoscopic pancreaticoduodenectomy for begnign and maliagnant diseases.Surg Endosc 2006,20:1045-1050
2 Takaori K,Tanigawa N.Laparoscopic pancreatic resection:the past,present,and future.Surg Today,2007,37:535-545
3 Corcione F,Marzano E,Cuccurullo D,et al.Distal pancreas surgery:outcome for 19 cases managed with a laparoscopic approach.Surg Endosc,2006,20:1729-1732
4 印慨,胡明根,郑成竹等.腹腔镜胃腔内手术1例.中国使用外科杂志,2004,2(24):62
5 Yeo C J,Cameron JL.The pancreas.In:Sabiston DC,ed.Sabiston textbook of surgery,the biological basis of modern surgical practice.15th ed.Philadelphia:WB Saunders Company,1997:1152
6 Bertrand Suc,Simon Msika,Abe Fingerhut,et al.Tomporary fibrin glue occlusion of main pancreatic duct in the prevention of intra - abdominal complication after pancreatic resection:prospective randomial trial[J].Ann Surg,2003,237(1):57-65.
7 Yeo CJ,Cameron JL,Lillemoe,et al.Does proiphylatic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy ?Results of a prospective randomized placebo-controlled trial[J]Ann surg,2000,232(3):419-429.
8 Conlon KC,Laboe D,Sminth A,et al.Prospective randomized clinical trial of the value of intrapefitoneal drainage after pan2creatic resection[J].Ann Surg,2001,234(4):487-493;discussion 493-494.
9 Strasberg SM,Drebin JA,Mokadam NA,et al.Prospective trial of a blood supply- based technique of pancreatiojejunostomy:effect on anatomotic failure in the Whipple procedure[J].Journal of American College of Surgeon,2002,194(6):746-758;discussion 759-760.
10 Fahy BN,Frey CF,Ho HS,et al.Morbidity,mortality,and technical factors of distal pancreatectomy[J].Am J Surg,2002,183(3):237-241.
1.Service FJ,McMahon MM,O'Brien PC,et al.Functioning insulinoma:incidence,recunence,and long-term survival of patients:a 60-year study.Mayo Clin Proc.1991;66(7):711-719.
2.Sweet MP.Izumisato Y,Way LW,et al.Laparoscopic enucleation of insulinomas.Arch Surg2007;142:1202-1204
3.孙润珠,董琳,李卓孙.胰岛细胞瘤误诊为癫痫所致精神障碍1例。上海精神医学,2006,18(4):213
4.Hiramoto JS,Feldstein VA,Laberge JM,et al.Intraoperative ultrasound and preoperative localization detects all occult insulinomas;discussion 1025-1026.Arch Surg,200l,136(9):1020-1025
5.Marbrut JY Lifante JC,Cherki S et al.Is preoperative localization of insulinomas necessary?Ann Chir,2001,126(9):850-856
6.彭雪亮,马桂英,袁建军.经腹超声诊断胰岛细胞瘤方法的研究.中原医刊,2007,34(4):33-34
7.Suzuki K,Takahashi S,Aiura K,et al.Evaluation of the usefulness of percutaneous transhepatic portal catheterization for preoperativelydiagnosing the localization of insulinomas.Pancreas,2002,24(1):96-102.
8.Isla A,Arbuckle JD,Kekis PB,et al.Laparoscopic management of insulinomas.Br J Surg.2009 Feb;96(2):185-190
9.Abboud B,Boujaoude J.Occult sporadic insulinoma:localization and surgical strategy.World J Gastroenterol.2008,14(5):657-65.
10.Toniato A,Foletto M.Laparoscopic versus open approach for solitary insulinoma.Surg Endosc,2008,22(1):258
1.Chol YB,Lira KS.Therapeutic laparoscopy for abdominal trauma.Surg Endosc 2003,17:421-427.
2.de Wilt JH,van Eijck CH,Hussain SM,et al.Laparoscopic spleen preserving distal pancreatectomy after blunt abdominal trauma.Injury 2003,34:233-234.
3.Reynolds EM,Curnow AJ.Laparoscopic distal pancreatectomy for traumatic pancreatic transection.J Pediatr Surg 2003,38:7-9.
4.Cuschieri A,Jakimowicz J J,van Spreeuwel J.Laparoscopic distal 70%pancreatectomy and splenectomy for chronic pancreatitis.Ann Surg 1996,223:280-285.
5.Fernandez-Cruz L,Saenz A,Astudillo E,et al.Laparoscopic pancreatic surgery in patients with chronic pancreatitis.Surg Endosc 2002,16:996-1003.
6.Ballestra LC,Bastida VX,Bettonica LC,et al.Laparoscopic management of acute biliary pancreatitis.Surg Endosc,1997,11(7):718- 721.
7.Bucher P,Pugin F,Morel P.Minimally invasive necrosectomy for infected necrotizing pancreatitis.Pancreas 2008,36(2):113-9
8.周总光,袁朝新,孙炜.急性重症胰腺炎腹腔镜手术治疗的临床研究.中华外科杂志,2001,39:272-274
9.Adamson GD,Cuschier A.Multimedia article laparoscopic infracolic necrosectomy for infected pancreatic necrosis.Surg Endosc 2003,17:1675-1681.
10.许军,孙备,白雪巍,等.经腹腔镜灌沈治疗早期重症胰腺炎.哈尔滨医科大学学报,2003,37:336-339。
11.Zhu JF,Fan XH,Zhang XH.Laparoscopic treatment of severe acute pancreatitis.Surg Endosc 2001,15(2):146- 148.
12.Park AE,Heniford BT.Therapeutic laparoscopy of the pancreas.Ann Surg 2002,236:149-158
13.Aljarabah M,Ammori BJ.Laparoscopic and endoscopic approaches for drainage of pancreatic pseudocysts:a systematic review of published series.Surg Endosc 2007,21:1936-1944
14.De Rubertis BG,Mc Ginty J,Rivera M,et al.Laparoscopic distal pancreatectomy for inflammatory pseudotumor of the pancreas.Surg Endosc 2004,18:1001.
15.De Vroede M,Bax NM,Brusgaard K,et al.Laparoscopic diagnosis and cure of hyperinsulinism in two cases of focal adenomatous hyperplasia in infancy.Pediatrics 2004,114:520-522
16.Edwin B,Mala T,Mathisen O,et al.Laparoscopic resection of the pancreas:a feasibility study of the short-term outcome.Surg Endosc 2004,18:407-411
17.Assalia A,Gagner M.Laparoscopic pancreatic surgery for islet cell tumors of the pancreas.Word J Surg 2004;28:1239-1247
18.Service F J,McMahon MM,O'Brien PC,et al.Functioning insulinoma:incidence,recurrence,and long-term survival of patients:a 60-year study.Mayo Clin Proc 1991,66:711-719.
19.Gagner M,Pomp A,Herrera MF.Early experience with laparoscopic resections of islet cell tumors.Surgery 1996,120:1051-1054.
20.Ayav A,Bresler L,Brunaud L,et al.Laparoscopic approach for solitary insulinorna:a multicentre study.Langenbecks Arch Surg 2005,390:134-140.
21.Fernandez-Cruz L,Saenz A,Astudillo E,et al.Outcome of laparoscopic pancreatic surgery:endocrine and nonendocrine tumors.World J Surg 2002,26:1057-1065.
22.Lo CY,Chan WF,Lo CM,et al.Surgical treatment of pancreatic insulinomas in the era of laparoscopy.Surg Endosc 2004,18:297-230.
23.Sweet MP.Izumisato Y,Way LW,et al.Laparoscopic enucleation of insulinomas.Arch Surg2007,142:1202-1204
24.赵国栋,刘荣,罗英,等.完全腹腔镜胰腺钩突部胰岛细胞瘤剜除术1例报告.中国微创外科杂志,2008,8(9):845.
25.Luo Y,Liu R,Hu MG,et al.Laparoscopic Surgery for Pancreatic Insulinomas:A Single-Institution Experience of 29 Cases.J Gastrointest Surg,200913(5):945-950
26.刘荣,胡明根,罗英,等.腹腔镜胰岛细胞瘤切除30例临床报告.中华外科杂志,2008,46(23):1766-1768。
27.Zhao YP,Cong L,Zhang TP,et al.Diagnosis and treatment of 404 cases of insulinoma.Zhongguo Shiyong Waike Zazhi,2008,28(5):357-359
28.Ammori B J,El-Dhuwaib Y,Ballester P,et al.Laparoscopic distal pancreatectomy for neuroendocrine tumors of the pancreas.Hepatogastroenterology 2005,52:620-624.
29.Yada K,Hirano S,Himeno Y,et al.Laparoscopic resection for nonfunctioning small glucagon-producing tumor:report of a case and review of the literature.J Hepatobiliary Pancreat Surg 2003,10:382-385.
30.Chan WF,Lo CY,Lo CM,et al.Laparoscopic resection of a pancreatic polypeptidoma with a solitary liver metastasis.Surg Endosc 2004,18:554-556.
31.Fernandez-Cruz L,Martinez I,Cesar-Borges G,et al.Laparoscopic surgery in patients with sporadic and multiple insulinomas associated with multiple endocrine neoplasia type 1.J Gastrointest Surg 2005,9:381-388.
32.Fernandez-Cruz L,Martinez I,Gilabert R,et al.Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas.J Gastrointest Surg 2004,8:493-501.
33.Han HS,Min SK,Lee HK,et al.Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for benign pancreas neoplasm.Surg Endosc 2005,19:1367-1369.
34.Khanna A,Koniaris LG,Nakeeb A,et al.Laparoscopic spleen-preserving distal pancreatectomy.J Gastrointest Surg2005,9:733-738.
35.刘荣,周宁新,黄志强,等.腹腔镜胰体尾切除术的临床应用.消化外科,2005,4(4):237-239
36.刘荣,胡明根,周宁新,等.腹腔镜胰体尾切除术的临床应用(附5例报告).腹腔镜外科杂志,2006,11(4):271-273
37.Watanabe Y,Sato M,Kikkawa H,et al.Spleen-preserving laparoscopic distal pancreatectomy for cystic adenoma.Hepatogastroenterology 2002,49:148-152.
38.Matsumoto T,Hirano S,Yada K,Himeno Y,et al.Safety and effi cacy of laparoscopic distal pancreatectomy for the treatment of pancreatic disease.J Hepatobiliary Pancreat Surg 2005,12:65-70.
39.Dulucq JL,Wintringer P,Stabilini C,et al.Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution.Surg Endosc 2005,19:1028-1034.
40.Mabrut JY,Fernandez-Cruz L,Azagra JS,et al.Hepatobiliary and Pancreatic Section(HBPS) of the Royal Belgian Society of Surgery,Belgian Group tbr Endoscopic Surgery(BGES),Club Coelio.Laparoscopic pancreatic resection:results of a multicenter European study of 127 patients.Surgery 2005,137:597-605.
41.Staudacher C,Orsenigo E,Baccari P,et al.Laparoscopic assisted duodenopancreatectomy.Surg Endosc 2005,19:352-356.
42.Palanivelu C.Art of laparoscopic surgery-Text book and atlas.1 st ed.vol.2.Coimbatore:Jaya Publication,2005.p.911-940.
44.Au-Yong IT,Wemyss-Holden S,Lloyd DM.Laparoscopic distal pancreatectomy for lymphoepithelial cyst of the pancreas.JSLS,2004,8:389-390.
45.Hamada T,Isaji S,Mizuno S,et al.Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor:report of a case.Surg Today,2004,34:878-81.
46.Gruessner RW,Kandaswamy R,Denny R.Laparoscopic simultaneous nephrectomy and distal pancreatectomy from a live donor.J Am Coll Surg 2001,193:333-7.
47.Tan M,Kandaswamy R,Sutherland DE,et al.Laparoscopic donor distal pancreatectomy for living donor pancreas and pancreas-kidney transplantation.Am J Transplant 2005,5:1966-1970.
48.牟一平,陈肖敏,徐晓武.等.腹腔镜下序贯式外引流和内引流术治疗胰腺假性囊肿一例,中华普通外科杂志,2005,20(7):413
49.Iihara M,Obara T.Recent advances in minimally invasive pancreatic surgery.Asian J Surg,2003,26(2):86- 91.
50.Tagaya N,Kasama K,Suzuki N,et al.Laparoscopic resection of the pancreas and review of the literature.Surg Endosc,2003,17:201-206.
51.Park B J,Alexander HR,Libutti SK,et al.Operative management of islet-cell tumors arising in the head of the pancreas.Surgery,1998,124:1056-1061.
52.Gianluigi M,Giovanni B,Micaela P,et al.Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients.Annls of surgery 2007,246:77-82
53.Kim SC,Park KT,Hwang JW,et al.Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution.Surg Endosc 2008,22:2261-2268
54.牟一平,柴振中.腹腔镜在胰腺囊性疾病中的应用.临床外科杂志,2008,16(11):726-728。
55.王港,修典荣,马朝来.腹腔镜胰腺远端切除术26例.中国微创外科杂志,2009,9(1):5-7
56.Warshaw AL.Conservation of the spleen with distal pancreatectomy.Arch Surg,1988,123:550-553
57.Kaneko H,Takagi S,Joubara N,et al.Laparoscopy-assisted Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.J Hepatobiliary Pancreat Surg,2004,11(6):397-401
58.Suzuki O,Tanaka S,Hirano S,et al.Efficacy of the Electrothermal Bipolar Vessel Sealer in Laparoscopic Spleen-Preserving Distal Pancreatectomy with Conservation of the Splenic Artery and Vein.J Gastrointest Surg,2009,13:155-158
59.牟一平,陈其龙.腹腔镜胰体尾切除术的手术经验.肝胆外科,2008,16(3):168-170
60.Takada M,Ichihara T,Toyama H,et al.Retroperitoneoscopic laparoscopic distal pancreatectomy with spleen salvage.Hepatogastroenterology 2002,49:925 - 927.
61.Orsenigo E,Baccari P,Bissolotti G,Staudacher C.Laparoscopic central pancreatectomy.Am J Surg 2006,191:549-52.
62.Gagner M,Pomp A.Laparoscopic pylorus-preserving pancreatoduodenectomy.Surg Endosc 1994,8:408-410
63.Gagner M,Pomp A.Laparoscop ic pancreatic resection:is it worthwhile? J Gastrointest Surg 1997,1(1):20 - 26.
64.卢榜裕,陆文奇,李杰,等.电视腹腔镜胰十二指肠切除术5例报告.中国微创外科杂志,2005,5(11):877-879
65.Takaori K,Tanigawa N.Laparoscopic pancreatic resection:the past,present,and future.Surg Today,2007,37:535-545
66.Dulucq JL,Wintringer P,Mahajna A.Laparoscopic pancreaticoduodenectomy for begnign and maliagnant diseases.Surg Endosc 2006,20:1045-1050
67.Palanivelu C,Jani K,Senthilnathan P,et al.Laparoscopic pancreaticoduodenectomy:technique and outcomes[J].J Am Coll Surg,2007,205(2):222-230
68.Mikami DJ,Melvin WS.Robotic assisted pancreatic surgery.Problems in General Surgery 2003,20:46-50
69.Koffron AJ,Auffenberg G,Kung R,et al.Evaluation of 300 minimally invasive liver resections at a single institution:less is more.Ann Surg 2007,246(3):385-392,discussion 392-394
2.Gagner M,Pomp A.Laparoscopic pylorus-preserving pancreatoduodenectomy[J].Surg Endosc,1994,8(5):408-410
3.Cuschieri A,Jakimowicz J J,van Spreeuwel J.Laparoscopic distal 70%pancreatectomy and splenectomy for chronic pancreatitis.Ann Surg 1996,223:280-285.
4.Tagaya N,Kasama K,Suzuki N,et al.Laparoscopic resection of the pancreas and review of the literature.Surg Endosc,2003,17:201 -206.
5.Pierce RA,Spitler JA,Hawkins WG,et al.Outcomes analysis of laparoscopic resection of pancreatic neoplasms.Surg Endosc,2007,21:579-586
6.叶建宇,周汉新,彭毅等.腹腔镜腆体尾(保脾)切除术.中国微创外科杂志,2001(11):262-265.
7.王港,修典荣,马朝来.腹腔镜胰腺远端切除术26例.中国微创外科杂志,2009,9(1):5-7.
8.牟一平,陈其龙.腹腔镜胰体尾切除术的手术经验.肝胆外科,2008,16(3):168-170.
9.刘兴国.腹腔镜胰腺外科的应用解剖学及临床研究.第一军医大学级博士学位论文2004:4-9
10.王健本.胰.见裘法祖,王健本,张枯曾主编,腹部外科临床解剖学.济南山东科学技术出版社,200l第1版:225-248
11.孙庆峰,帏德恩,李玉兰,等.胰头十二指肠区域血管的应用解剖学研究哈尔滨医科大学学报,2003,37(5):409-411
12.姜树学.腹部.见姜树学.马述盛主编.断面解剖与CT、MRI、ECT对比图集.沈阳,辽宁科学技术出版社,2006年,第1版:185-188
13.邱实.腹部.见邱实主编.临床实用断层影像解剖学.郑州,河南医科大学出版社,2001年第1版:247-248。
14.印慨,胡明根,郑成竹等。腹腔镜胃腔内胃手术1例。中国实用外科杂志, 2004,24(2):118
15.印慨,郑成竹,邹晓平,孙振兴,胡明根,胡兵,李兆申。腹腔镜手术的新概念--腹腔镜胃腔内手术。中华胃肠外科杂志,2004,7(3):181-182
1 Dulucq JL,Wintringer P,Mahajna A.Laparoscopic pancreaticoduodenectomy for begnign and maliagnant diseases.Surg Endosc 2006,20:1045-1050
2 Takaori K,Tanigawa N.Laparoscopic pancreatic resection:the past,present,and future.Surg Today,2007,37:535-545
3 Corcione F,Marzano E,Cuccurullo D,et al.Distal pancreas surgery:outcome for 19 cases managed with a laparoscopic approach.Surg Endosc,2006,20:1729-1732
4 印慨,胡明根,郑成竹等.腹腔镜胃腔内手术1例.中国使用外科杂志,2004,2(24):62
5 Yeo C J,Cameron JL.The pancreas.In:Sabiston DC,ed.Sabiston textbook of surgery,the biological basis of modern surgical practice.15th ed.Philadelphia:WB Saunders Company,1997:1152
6 Bertrand Suc,Simon Msika,Abe Fingerhut,et al.Tomporary fibrin glue occlusion of main pancreatic duct in the prevention of intra - abdominal complication after pancreatic resection:prospective randomial trial[J].Ann Surg,2003,237(1):57-65.
7 Yeo CJ,Cameron JL,Lillemoe,et al.Does proiphylatic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy ?Results of a prospective randomized placebo-controlled trial[J]Ann surg,2000,232(3):419-429.
8 Conlon KC,Laboe D,Sminth A,et al.Prospective randomized clinical trial of the value of intrapefitoneal drainage after pan2creatic resection[J].Ann Surg,2001,234(4):487-493;discussion 493-494.
9 Strasberg SM,Drebin JA,Mokadam NA,et al.Prospective trial of a blood supply- based technique of pancreatiojejunostomy:effect on anatomotic failure in the Whipple procedure[J].Journal of American College of Surgeon,2002,194(6):746-758;discussion 759-760.
10 Fahy BN,Frey CF,Ho HS,et al.Morbidity,mortality,and technical factors of distal pancreatectomy[J].Am J Surg,2002,183(3):237-241.
1.Service FJ,McMahon MM,O'Brien PC,et al.Functioning insulinoma:incidence,recunence,and long-term survival of patients:a 60-year study.Mayo Clin Proc.1991;66(7):711-719.
2.Sweet MP.Izumisato Y,Way LW,et al.Laparoscopic enucleation of insulinomas.Arch Surg2007;142:1202-1204
3.孙润珠,董琳,李卓孙.胰岛细胞瘤误诊为癫痫所致精神障碍1例。上海精神医学,2006,18(4):213
4.Hiramoto JS,Feldstein VA,Laberge JM,et al.Intraoperative ultrasound and preoperative localization detects all occult insulinomas;discussion 1025-1026.Arch Surg,200l,136(9):1020-1025
5.Marbrut JY Lifante JC,Cherki S et al.Is preoperative localization of insulinomas necessary?Ann Chir,2001,126(9):850-856
6.彭雪亮,马桂英,袁建军.经腹超声诊断胰岛细胞瘤方法的研究.中原医刊,2007,34(4):33-34
7.Suzuki K,Takahashi S,Aiura K,et al.Evaluation of the usefulness of percutaneous transhepatic portal catheterization for preoperativelydiagnosing the localization of insulinomas.Pancreas,2002,24(1):96-102.
8.Isla A,Arbuckle JD,Kekis PB,et al.Laparoscopic management of insulinomas.Br J Surg.2009 Feb;96(2):185-190
9.Abboud B,Boujaoude J.Occult sporadic insulinoma:localization and surgical strategy.World J Gastroenterol.2008,14(5):657-65.
10.Toniato A,Foletto M.Laparoscopic versus open approach for solitary insulinoma.Surg Endosc,2008,22(1):258
1.Chol YB,Lira KS.Therapeutic laparoscopy for abdominal trauma.Surg Endosc 2003,17:421-427.
2.de Wilt JH,van Eijck CH,Hussain SM,et al.Laparoscopic spleen preserving distal pancreatectomy after blunt abdominal trauma.Injury 2003,34:233-234.
3.Reynolds EM,Curnow AJ.Laparoscopic distal pancreatectomy for traumatic pancreatic transection.J Pediatr Surg 2003,38:7-9.
4.Cuschieri A,Jakimowicz J J,van Spreeuwel J.Laparoscopic distal 70%pancreatectomy and splenectomy for chronic pancreatitis.Ann Surg 1996,223:280-285.
5.Fernandez-Cruz L,Saenz A,Astudillo E,et al.Laparoscopic pancreatic surgery in patients with chronic pancreatitis.Surg Endosc 2002,16:996-1003.
6.Ballestra LC,Bastida VX,Bettonica LC,et al.Laparoscopic management of acute biliary pancreatitis.Surg Endosc,1997,11(7):718- 721.
7.Bucher P,Pugin F,Morel P.Minimally invasive necrosectomy for infected necrotizing pancreatitis.Pancreas 2008,36(2):113-9
8.周总光,袁朝新,孙炜.急性重症胰腺炎腹腔镜手术治疗的临床研究.中华外科杂志,2001,39:272-274
9.Adamson GD,Cuschier A.Multimedia article laparoscopic infracolic necrosectomy for infected pancreatic necrosis.Surg Endosc 2003,17:1675-1681.
10.许军,孙备,白雪巍,等.经腹腔镜灌沈治疗早期重症胰腺炎.哈尔滨医科大学学报,2003,37:336-339。
11.Zhu JF,Fan XH,Zhang XH.Laparoscopic treatment of severe acute pancreatitis.Surg Endosc 2001,15(2):146- 148.
12.Park AE,Heniford BT.Therapeutic laparoscopy of the pancreas.Ann Surg 2002,236:149-158
13.Aljarabah M,Ammori BJ.Laparoscopic and endoscopic approaches for drainage of pancreatic pseudocysts:a systematic review of published series.Surg Endosc 2007,21:1936-1944
14.De Rubertis BG,Mc Ginty J,Rivera M,et al.Laparoscopic distal pancreatectomy for inflammatory pseudotumor of the pancreas.Surg Endosc 2004,18:1001.
15.De Vroede M,Bax NM,Brusgaard K,et al.Laparoscopic diagnosis and cure of hyperinsulinism in two cases of focal adenomatous hyperplasia in infancy.Pediatrics 2004,114:520-522
16.Edwin B,Mala T,Mathisen O,et al.Laparoscopic resection of the pancreas:a feasibility study of the short-term outcome.Surg Endosc 2004,18:407-411
17.Assalia A,Gagner M.Laparoscopic pancreatic surgery for islet cell tumors of the pancreas.Word J Surg 2004;28:1239-1247
18.Service F J,McMahon MM,O'Brien PC,et al.Functioning insulinoma:incidence,recurrence,and long-term survival of patients:a 60-year study.Mayo Clin Proc 1991,66:711-719.
19.Gagner M,Pomp A,Herrera MF.Early experience with laparoscopic resections of islet cell tumors.Surgery 1996,120:1051-1054.
20.Ayav A,Bresler L,Brunaud L,et al.Laparoscopic approach for solitary insulinorna:a multicentre study.Langenbecks Arch Surg 2005,390:134-140.
21.Fernandez-Cruz L,Saenz A,Astudillo E,et al.Outcome of laparoscopic pancreatic surgery:endocrine and nonendocrine tumors.World J Surg 2002,26:1057-1065.
22.Lo CY,Chan WF,Lo CM,et al.Surgical treatment of pancreatic insulinomas in the era of laparoscopy.Surg Endosc 2004,18:297-230.
23.Sweet MP.Izumisato Y,Way LW,et al.Laparoscopic enucleation of insulinomas.Arch Surg2007,142:1202-1204
24.赵国栋,刘荣,罗英,等.完全腹腔镜胰腺钩突部胰岛细胞瘤剜除术1例报告.中国微创外科杂志,2008,8(9):845.
25.Luo Y,Liu R,Hu MG,et al.Laparoscopic Surgery for Pancreatic Insulinomas:A Single-Institution Experience of 29 Cases.J Gastrointest Surg,200913(5):945-950
26.刘荣,胡明根,罗英,等.腹腔镜胰岛细胞瘤切除30例临床报告.中华外科杂志,2008,46(23):1766-1768。
27.Zhao YP,Cong L,Zhang TP,et al.Diagnosis and treatment of 404 cases of insulinoma.Zhongguo Shiyong Waike Zazhi,2008,28(5):357-359
28.Ammori B J,El-Dhuwaib Y,Ballester P,et al.Laparoscopic distal pancreatectomy for neuroendocrine tumors of the pancreas.Hepatogastroenterology 2005,52:620-624.
29.Yada K,Hirano S,Himeno Y,et al.Laparoscopic resection for nonfunctioning small glucagon-producing tumor:report of a case and review of the literature.J Hepatobiliary Pancreat Surg 2003,10:382-385.
30.Chan WF,Lo CY,Lo CM,et al.Laparoscopic resection of a pancreatic polypeptidoma with a solitary liver metastasis.Surg Endosc 2004,18:554-556.
31.Fernandez-Cruz L,Martinez I,Cesar-Borges G,et al.Laparoscopic surgery in patients with sporadic and multiple insulinomas associated with multiple endocrine neoplasia type 1.J Gastrointest Surg 2005,9:381-388.
32.Fernandez-Cruz L,Martinez I,Gilabert R,et al.Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas.J Gastrointest Surg 2004,8:493-501.
33.Han HS,Min SK,Lee HK,et al.Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for benign pancreas neoplasm.Surg Endosc 2005,19:1367-1369.
34.Khanna A,Koniaris LG,Nakeeb A,et al.Laparoscopic spleen-preserving distal pancreatectomy.J Gastrointest Surg2005,9:733-738.
35.刘荣,周宁新,黄志强,等.腹腔镜胰体尾切除术的临床应用.消化外科,2005,4(4):237-239
36.刘荣,胡明根,周宁新,等.腹腔镜胰体尾切除术的临床应用(附5例报告).腹腔镜外科杂志,2006,11(4):271-273
37.Watanabe Y,Sato M,Kikkawa H,et al.Spleen-preserving laparoscopic distal pancreatectomy for cystic adenoma.Hepatogastroenterology 2002,49:148-152.
38.Matsumoto T,Hirano S,Yada K,Himeno Y,et al.Safety and effi cacy of laparoscopic distal pancreatectomy for the treatment of pancreatic disease.J Hepatobiliary Pancreat Surg 2005,12:65-70.
39.Dulucq JL,Wintringer P,Stabilini C,et al.Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution.Surg Endosc 2005,19:1028-1034.
40.Mabrut JY,Fernandez-Cruz L,Azagra JS,et al.Hepatobiliary and Pancreatic Section(HBPS) of the Royal Belgian Society of Surgery,Belgian Group tbr Endoscopic Surgery(BGES),Club Coelio.Laparoscopic pancreatic resection:results of a multicenter European study of 127 patients.Surgery 2005,137:597-605.
41.Staudacher C,Orsenigo E,Baccari P,et al.Laparoscopic assisted duodenopancreatectomy.Surg Endosc 2005,19:352-356.
42.Palanivelu C.Art of laparoscopic surgery-Text book and atlas.1 st ed.vol.2.Coimbatore:Jaya Publication,2005.p.911-940.
44.Au-Yong IT,Wemyss-Holden S,Lloyd DM.Laparoscopic distal pancreatectomy for lymphoepithelial cyst of the pancreas.JSLS,2004,8:389-390.
45.Hamada T,Isaji S,Mizuno S,et al.Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor:report of a case.Surg Today,2004,34:878-81.
46.Gruessner RW,Kandaswamy R,Denny R.Laparoscopic simultaneous nephrectomy and distal pancreatectomy from a live donor.J Am Coll Surg 2001,193:333-7.
47.Tan M,Kandaswamy R,Sutherland DE,et al.Laparoscopic donor distal pancreatectomy for living donor pancreas and pancreas-kidney transplantation.Am J Transplant 2005,5:1966-1970.
48.牟一平,陈肖敏,徐晓武.等.腹腔镜下序贯式外引流和内引流术治疗胰腺假性囊肿一例,中华普通外科杂志,2005,20(7):413
49.Iihara M,Obara T.Recent advances in minimally invasive pancreatic surgery.Asian J Surg,2003,26(2):86- 91.
50.Tagaya N,Kasama K,Suzuki N,et al.Laparoscopic resection of the pancreas and review of the literature.Surg Endosc,2003,17:201-206.
51.Park B J,Alexander HR,Libutti SK,et al.Operative management of islet-cell tumors arising in the head of the pancreas.Surgery,1998,124:1056-1061.
52.Gianluigi M,Giovanni B,Micaela P,et al.Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients.Annls of surgery 2007,246:77-82
53.Kim SC,Park KT,Hwang JW,et al.Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution.Surg Endosc 2008,22:2261-2268
54.牟一平,柴振中.腹腔镜在胰腺囊性疾病中的应用.临床外科杂志,2008,16(11):726-728。
55.王港,修典荣,马朝来.腹腔镜胰腺远端切除术26例.中国微创外科杂志,2009,9(1):5-7
56.Warshaw AL.Conservation of the spleen with distal pancreatectomy.Arch Surg,1988,123:550-553
57.Kaneko H,Takagi S,Joubara N,et al.Laparoscopy-assisted Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.J Hepatobiliary Pancreat Surg,2004,11(6):397-401
58.Suzuki O,Tanaka S,Hirano S,et al.Efficacy of the Electrothermal Bipolar Vessel Sealer in Laparoscopic Spleen-Preserving Distal Pancreatectomy with Conservation of the Splenic Artery and Vein.J Gastrointest Surg,2009,13:155-158
59.牟一平,陈其龙.腹腔镜胰体尾切除术的手术经验.肝胆外科,2008,16(3):168-170
60.Takada M,Ichihara T,Toyama H,et al.Retroperitoneoscopic laparoscopic distal pancreatectomy with spleen salvage.Hepatogastroenterology 2002,49:925 - 927.
61.Orsenigo E,Baccari P,Bissolotti G,Staudacher C.Laparoscopic central pancreatectomy.Am J Surg 2006,191:549-52.
62.Gagner M,Pomp A.Laparoscopic pylorus-preserving pancreatoduodenectomy.Surg Endosc 1994,8:408-410
63.Gagner M,Pomp A.Laparoscop ic pancreatic resection:is it worthwhile? J Gastrointest Surg 1997,1(1):20 - 26.
64.卢榜裕,陆文奇,李杰,等.电视腹腔镜胰十二指肠切除术5例报告.中国微创外科杂志,2005,5(11):877-879
65.Takaori K,Tanigawa N.Laparoscopic pancreatic resection:the past,present,and future.Surg Today,2007,37:535-545
66.Dulucq JL,Wintringer P,Mahajna A.Laparoscopic pancreaticoduodenectomy for begnign and maliagnant diseases.Surg Endosc 2006,20:1045-1050
67.Palanivelu C,Jani K,Senthilnathan P,et al.Laparoscopic pancreaticoduodenectomy:technique and outcomes[J].J Am Coll Surg,2007,205(2):222-230
68.Mikami DJ,Melvin WS.Robotic assisted pancreatic surgery.Problems in General Surgery 2003,20:46-50
69.Koffron AJ,Auffenberg G,Kung R,et al.Evaluation of 300 minimally invasive liver resections at a single institution:less is more.Ann Surg 2007,246(3):385-392,discussion 392-394