关键词: 胰腺神经内分泌肿瘤, 腹腔镜手术, 功能保留性胰腺手术, 疗效

Abstract: Objective To investigate the short-term efficacy of laparoscopic functional retention operation in patients with pancreatic neuroendocrineneoplasm（PNENs）. Methods A total of 67 patients with PNENs were recruited in our hospital between March 2014 and February 2017,and 33 patients received laparoscopic pancreatic functional retention surgery serving as observation group,and out of them,local tumor resection was conducted in 8,middle segment pancreatectomy （MSP） in 11 and pylorus preserving pancreaticoduode nectomy （PPPD in 14 patients,and 34 patients were operated by traditional surgery serving as the control group. Serum glucagon,gastrin,somatostatin and insulin levels were detected by ELISA. Results In the observation group, the operative time was significantly shorter than that in the control group [（163.7±21.3） min vs. （179.4±20.8） min,P<0.01], the amount of intraoperative blood loss was significantly less than in the control group [（267.8±36.1） ml vs. （315.2±35.6） ml,P<0.01],the anal venting time was significantly shorter than that in the control group [（22.4±6.2） h vs.（29.1±6.5） h,P<0.01] and the post-operational stay was significantly shorter than that in the control group [（6.9±1.4） d vs. （7.5±1.2） days,P<0.05];at the end of 1 week post-operation,serum glucagon levels was （134.9±44.8） ng/L,much lower than [（175.3±44.2）ng/L,P<0.01],serum gastrin level was （354.6±62.7） pg/L,muchi lower than [（435.9±63.3） pg/L,P<0.01],while serum somatostatin level was（59.0±5.4） ng/L,significantly higher [（42.1±5.8） ng/L,P<0.01],and serum insulin level was （9.8±1.5） μU/ml,significantly higher [（7.6±1.4） μU/ml,P<0.01] in the control;the incidences of complications, such as new diabetes, gastrointestinal anastomotic fistula, gastric emptying dysfunction, infection, and portal thrombosis was 12.1%,much lower than 26.5% （P<0.05） in the control and at the end of one year followed-up, the tumor recurrence was not significantly different between the two groups （9.1% vs. 17.6%,P>0.05）. Conclusion Laparoscopic functional retention pancreatic surgery might be preserve the pancreatic functions in patients with PNENs with less post-operational complications and improve early recovery of the patients.

Key words: Neuroendocrineneoplasm, Laparoscopic surgery, Functional retention pancreatic surgery, Efficacy