腹腔镜保脾胰体尾切除八例的手术经验  

Laparoscopic distal pancreatectomy with preservation of the spleen

作　　者：严加费[1] 牟一平[1] 徐晓武[1] 陈其龙[1] 朱一平[1] 王松彪[1] 

机构地区：[1]浙江大学医学院邵逸夫医院肝胆外科,杭州310016

出　　处：《中华普外科手术学杂志（电子版）》2009年第1期23-25,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的总结保留脾脏腹腔镜胰体尾切除术的临床经验与手术技巧。方法自2003年11月至2008年2月,我们对8例胰体尾部良性占位病变患者施行保留脾脏腹腔镜胰体尾切除术。结果本组8例均在腹腔镜下完成,其中1例合并胆囊切除,1例合并右肾上腺肿瘤切除,1例合并子宫肌瘤挖出、左卵巢畸胎瘤挖出,1例合并子宫肌瘤挖出。本组手术时间120～290min,出血量150～600ml。术后住院时间3～9d,无胰漏发生。术后病理诊断:潴留性囊肿2例,浆液性囊腺瘤1例,黏液性囊腺瘤2例,上皮性囊肿2例,先天性囊肿1例。随访9～60个月,症状消失,未见复发。结论对于胰体尾部良性病变,可行保留脾脏的胰体尾部切除,对拥有丰富高级腹腔镜手术经验的术者,开展保留脾脏的腹腔镜胰体尾切除术是安全可行的。Objective To summarize the experience in laparoscopic distal pancreatectomy with preservation of the spleen. Methods From November 2003 to February 2008, eight patients with distal pancreatic lesions underwent laparoscopic distal pancreatectomy with preservation of the spleen. Results All operations were successful with the operative time from 120 N 290 minutes, and intraoperative blood loss varied from 150 to 600 ml. One patient underwent the operation associated with cholycystectomy, 1 with resection of right adrenal adenoma, 1 with laparoscopic myomectomy and left ovarian teratomectomy, 1 with laparoscopic myomectomy. All patients were discharged 3 to 9 days later. The pathological diagnoses showed 2 patients with retained cyst, 1 patient with serous cystadenoma, 2 patients with mucious cystadenoma, 2 patients with epithelial cyst of the pancreas, and 1 patient with congenital cyst. All patients＇symptoms disappeared after operation and no recurrence was observed during the follow-up period ranged from 9 to 60 months. Conclusions Laparoscopic distal pancreatectomy with preservation of the spleen is the suitable for the distal pancreatic benign lesion. It is recommended for the surgeons with abundant experiences in advanced laparoscopic surgery.

关 键 词：胰腺肿瘤 腹腔镜 胰腺切除术 脾 

分 类 号：R657.5[医药卫生—外科学] R657.4[医药卫生—临床医学]