空军军医大学学报2025，Vol.46Issue(9)：1163-1169,7.DOI:10.13276/j.issn.2097-1656.2025.09.008
精准微创在腹腔镜保脾胰体尾切除术中的疗效分析
Analysis of the efficacy of precision minimally invasive technique in laparoscopic spleen-preserving distal pancreatectomy
摘要
Abstract
Objective To comparatively study the clinical efficacy and safety between Kimura and Warshaw procedures in laparoscopic spleen-preserving distal pancreatectomy(LSPDP).Methods A retrospective cohort study design was conducted,involving 102 patients who underwent LSPDP from June 2018 to June 2023,with 62 cases in the Kimura group and 40 cases in the Warshaw group.Perioperative indicators,splenic function preservation,and complications were compared between the two groups.Results The Warshaw group exhibited significantly higher incidence of splenic infarction than the Kimura group(22.5％vs 3.2％,P=0.003),with 3 cases of overwhelming post-splenectomy infection observed.Tuftsin levels at 6 months postoperatively were higher in the Kimura group[(0.82±0.11)mg/L vs(0.71±0.13)mg/L,P=0.002)].The Kimura group demonstrated shorter operative time[(185.6±35.2)min vs(215.4±42.1)min,P=0.012)]and reduced blood loss[(152.8±89.5)mL vs(298.6±120.7)mL,P＜0.001)].Multivariate analysis identified type Ⅳ splenic vessels(OR=6.63)and intraoperative blood loss＞300 mL(OR=4.77)as independent risk factors for spleen preservation failure.Conclusion The Kimura procedure demonstrates advantages in reducing splenic infarction risk,preserving immune function,and enhancing surgical safety through maintenance of splenic hilar vascular integrity,providing practical evidence for"Functional Spleen Preservation".关键词
腹腔镜/胰腺切除术/Kimura法/Warshaw法/围手术期并发症/脾梗死/脾门血管/脾切除后凶险性感染Key words
laparoscopic/pancreatectomy/Kimura's method/Warshaw's method/perioperative complications/splenic infarction/splenic hilar vascular/overwhelming post-splenectomy infection分类
医药卫生引用本文复制引用
黄鑫,李晓勇,杨雁灵,李晓东,顾昊武,南博,铁静静,张宁,王振华,吴菲菲,王亚云..精准微创在腹腔镜保脾胰体尾切除术中的疗效分析[J].空军军医大学学报,2025,46(9):1163-1169,7.基金项目
陕西省自然科学基础研究计划项目(2024JC-ZDXM-60) （2024JC-ZDXM-60）
