KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI NỐI MẬT RUỘT VÀ VỊ TRÀNG Ở BỆNH NHÂN U ĐẦU TUỴ GIAI ĐOẠN TIẾN TRIỂN

Abstract

Background: Pancreaticoduodenectomy offers the posibility of radical resection for pancreatic head cancer. However, up to 80% of cases of pancreatic head cancer are diagnosed at an advanced stage and are unsuitable for this surgery. Cholecystojejunostomy and gastrojejunostomy is an effective palliative treatment option for patients with advanced-stage disease who have biliary or duodenal obstruction. We performed laparoscopic cholecystojejunostomy and gastrojejunostomy instead of conventional open surgery in order to provide the benefits of minimal invasive surgery for patients. Methods: Retrospective cross-sectional description. Inclusion criteria: patients diagnosed with advanced-stage pancreatic head tumors underwent laparoscopic cholecystojejunostomy and gastrojejunostomy at the Hepatobiliary and Pancreatic Department of Cho Ray hospital from 10/2021 to 02/2023. Exclusion criteria: Cases with missing research data in medical records. Results: We recruited 30 cases that met the study criteria. The average age was 63.9 ± 8.5 years, with a male-to-female ratio of 1:2. Clinical manifestations included abdominal pain (97%), jaundice (87%), and vomiting (27%). The tumor size was 4.3 ± 1.3 cm. 86.7% showed invasion into the SMV, and 26.7% had duodenal obstruction. The technical success rate was 100%, with no intraoperative complications. The average operative time was 171 ± 25.3 minutes, with a blood loss of 43.7 ± 18.1 ml. Postoperatively, the level of bilirubins and transaminases decreased significantly compared to preoperative levels. The postoperative vomiting rate was 3.3% which responded to medical treatment. There was no surgical complications or deaths after surgery. The average hospital stay was 6.95 days. Conclusion: Laparoscopic cholecystojejunostomy and gastrojejunostomy for the treatment of advanced-stages  pancreatic head cancer is a feasible and safe technique. However, this surgery requires skillful surgeons and the operative time is relatively long.