中国实用外科杂志2015，Vol.35Issue(12)：1325-1328,4.DOI:10.7504/CJPS.ISSN1005-2208.2015.12.19
腹腔镜胰体尾切除术选择策略临床研究
Laparoscopic resection of pancreatic body and tail: A report of 56 cases
摘要
Abstract
Objective To discuss the strategy and technique of laparoscopic distal pancreatectomy(LDP) in the treatment of tumors in the body or tail of the pancreas. Methods The clinical data of 56 cases of tumors in the body or tail of the pancreas performed LDP from April 2012 to June 2014 in Zhejiang Provincial People's Hospital and Zhangzhou Municipal Hospital of Fujian Province were analyzed retrospectively. Results Among the 56 cases, laparoscopic procedure was successfully performed in 53 cases, only 3 cases (5.4%) were converted to laparotomy. LDP with splenectomy, spleen-preserving LDP with conservation of the spleen vessels(Kimura procedure), spleen-preserving LDP without conservation of the spleen vessels(Warshaw procedure)were performed in 31(58.5%),19(35.8%)and 3 cases(5.7%), respectively. The operation time was 70 to 230 mins with a time of(170±35)mins;the intraoperative blood loss was 50 to 310 mL with the mean volume of(110 ± 34)mL;the postoperative hospital stay was 5 to 35 days with the mean value of(9 ± 6)days. Postoperative complications included 13 cases of grade A pancreatic fistula (23.2%), 1 case (1.8%) of grade B pancreatic fistula and 1 case(1.8%)of intra-abdominal abscess, 2 cases of pneumonia(3.6%) . Radiology and pathology were analyzed postoperatively:12 cases of pancreatic duct carcinoma, 23 of boarderline tumors (>5cm), 2 of chronic pancreatitis were found in converting laparotomy, LDP with splenectomy and Warshaw procedure. All the Kimura procedures were performed in benign or boarderline tumors with diameters less than<5cm, with the spleen-preserving rate of 50%(22/44). Conclusion Well selected surgical procedures and path according to the tumorcharacteristics, size, location and the anatomic relationship with spleen vessels could effectively improve the safety and the spleen preservation rate in LDP.关键词
胰腺肿瘤/胰腺切除术/腹腔镜/保留脾脏胰体尾切除术Key words
pancreatic neoplasm/pancreatectomy/laparoscopy/spleen-preserving laparoscopic distal pancreatectomy分类
医药卫生引用本文复制引用
洪德飞,林志川,张宇华,张成武,孙晓东,吴伟顶,成剑,卢毅..腹腔镜胰体尾切除术选择策略临床研究[J].中国实用外科杂志,2015,35(12):1325-1328,4.基金项目
浙江省科技厅重大专项(No.2013C03046) （No.2013C03046）
浙江省卫计委重点学科重点资助项目(No.2015ZDA004) （No.2015ZDA004）
