保留脾脏的胰体尾切除术的选择与方法  

Indications and Techniques of Spleen-Preserving Distal Pancreatectomy

作　　者：吴向嵩[1] 陈德琴[2] 吴文广[3] 柳咏[4] 刘颖斌[3] 

机构地区：[1]温州医学院附属第一医院肝胆外科,浙江温州325000 [2]温州市第二人民医院肿瘤外科,浙江温州325000 [3]上海交通大学医学院附属新华医院普外科,上海200092 [4]扬州市第一人民医院普外科,江苏扬州225200

出　　处：《中国普外基础与临床杂志》2011年第1期17-20,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的研究保留脾脏的胰体尾切除术(SpDP)的可行性、安全性,探讨其选择及具体方法。方法对上海交通大学附属新华医院2004年1月至2007年12月期间施行的7例SpDP患者的临床资料进行回顾性分析。结果 6例成功施行保留脾血管的SpDP,1例成功施行部分脾血管切除的SpDP,手术时间(2.93±0.38)h,术中失血量为(392.86±109.65)ml。术后发生胰瘘1例,经保守治疗后好转出院。全组患者术后血小板计数最高值为(273±43.76)×109/L,术后住院时间为(17.86±8.07)d,住院期间无死亡病例。6例肿瘤患者术后随访(49.2±14.4)个月(30～70个月),未见肿瘤复发、转移征象。结论 SpDP是一种安全、可行的术式,对于胰体尾良性占位等合适的病例有一定的临床应用价值。Objective To investigate the feasibility and safety of spleen-preserving distal pancreatectomy（SpDP）,and to discuss the indications and techniques of SpDP.Methods The clinical data of seven patients underwent SpDP between January 2004 and December 2007 in Xinhua Hospital were analyzed retrospectively.Results Out of the seven cases,one case received the SpDP combined with partial splenic vessel resection,while the other cases received the SpDP with splenic vessel preservation.The operation time was（2.93±0.38） h and the intraoperative blood loss was（392.86±109.65） ml.Only one case suffered from pancreatic fistula,who finally recovered after medicine therapy and percutaneous drainage.There was no other complication or operative mortality.The postoperative platelet count was（273±43.76）×10^9/L and the postoperative hospital stay was（17.86±8.07） d.For six cases of patients,no recurrence and metastasis was found after the follow-up（49.2±14.4） months（30-72 months）.Conclusion SpDP is a safe and feasible procedure,which is worthy for selected cases such as benign neoplasm of the body and tail of the pancreas.

关 键 词：胰体尾病变 胰体尾切除术 保留脾脏 

分 类 号：R657.5[医药卫生—外科学]