目的：探讨完全机器人“3+2”模式下前入路与右后入路联合胰十二指肠切除术的初步临床经验。方法：回顾性分析2019 年7 月—2020 年2 月甘肃省人民医院普外临床中心采用前入路与右后入路法联合完全达芬奇机器人下胰十二指肠切除术（Total Robotic Pancreaticoduodenectomy，TRPD）的 9 例患者围手术期临床资料，观察手术疗效及术后并发症。结果：9 例患者均采用前入路与右后入路联合法成功实施TRPD，平均手术时间（418.89±23.15）min，平均术中出血量（361.11±102.40）ml，术中无中转开腹病例。术中输血1 例；术后无死亡病例；2 例患者出现胃排空障碍，2 例患者出现A 级胰瘘，经保守治疗好转出院。术后病检结果示：1 例十二指肠腺癌，4 例胆管癌，1 例胰腺实性假乳头瘤，3 例胰头导管癌。结论：完全机器人“3+2”模式下前入路与右后入路联合胰十二指肠切除术具有可行性和安全性。

Objective: To explore the preliminary clinical experience of total robotic pancreaticoduodenectomy with anterior and right posterior approach under“3+2”mode . Methods: The clinical data of 9 patients who underwent total robotic pancreatoduodenectomy (TRPD) with anterior and right posterior approach in Gansu Provincial People’s Hospital from July 2019 to February 2020 were retrospectively analyzed. The clinical efficacy and postoperative complications were observed.Results: TRPD with anterior and right posterior approach was successfully performed in all 9 patients, with an average operative time of (418.89±23.15) min and an average intraoperative blood loss of (361.11±102.40) ml, no conversion to open surgery occurred. Introperative transfusion was performed in 1 patient, no death occurred after operation. There were 2 cases of gastric emptying disorder and 2 cases of grade A pancreatic leakage. The postoperative pathological examination indicated 1 case of duodenal adenocarcinoma, 4 cases of cholangiocarcinoma, 1 case of solid-pseudopapillary tumors of pancreas and 3 cases of ductal carcinoma of pancreatic head. Conclusion: TRPD with anterior and right posterior approach under “3+2” mode is feasible and safe.

收稿日期：2021-03-22 录用日期：2021-04-16

Received Date: 2021-03-22 Accepted Date: 2021-04-16

基金项目：甘肃省人民医院院内科研资助项目（16GSSY2-5）

Foundation Item: Scientific Research Project of Gansu Provincial People’s Hospital (16GSSY2-5)

通讯作者：马云涛，Email：532005612@qq.com

Corresponding Author: MA Yuntao, Email: 532005612@qq.com

引用格式：郭进，詹渭鹏，狐鸣，等. 完全机器人“3+2”模式下前入路与右后入路联合胰十二指肠切除术的效果初探[J]. 机器人外科学杂志（中英文），2023，4（2）：99-104.

Citation: GUO J, ZHAN W P, HU M, et al. Total robotic pancreaticoduodenectomy with anterior and right posterior approach under“3+2”mode [J]. Chinese Journal of Robotic Surgery, 2023, 4(2): 99-104.

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