完全腹腔镜下保留脾脏胰体尾切除术12例分析  

Spleen- preserving laparoscopic distal pancreatectomy: a report of 12 cases from a single institution

作　　者：邱福南[1,2] 吴嘉艺 田毅峰[1] 赖智德[1] 周松强[1] 严茂林[1] 陈忠[1] 王耀东[1,2] 

机构地区：[1]福建省立医院肝胆外科,福州350001 [2]福建医科大学省立临床医学院,福州350001

出　　处：《临床肝胆病杂志》2014年第1期42-45,共4页Journal of Clinical Hepatology

摘　　要：目的探讨完全腹腔镜下保留脾脏胰体尾切除术（SPLDP）在治疗胰腺体尾部占位的安全性、可行性及操作技巧。方法对2008年10月至2012年12月完成的完全腹腔镜下SPLDP治疗胰体尾部占位12例（其中11例行Kimura法保留脾脏，1例行Warshaw法保留脾脏）的临床资料进行回顾性分析。结果12例SPLDP无中转开腹，平均手术时间172．5min（120—240min），术中平均出血量191，7m1（50～400m1），术后平均住院时间9．5d（4—25d），3例术后出现B级胰痿，经充分引流后治愈。术后病理诊断胰腺实性假乳头状瘤4例，胰腺神经内分泌癌2例，胰岛细胞瘤2例，胰腺假性囊肿2例，胰腺囊腺瘤2例。术后随访6～51个月，效果良好，均未出现糖尿病和肿瘤复发。结论对良性及低度恶性胰体尾肿瘤，完全腹腔镜下SPLDP是安全可行的。Objective To investigate the safety, feasibility, and operation skills of spleen - preserving laparoscopic distal pancreatectomy （SPLDP） in the treatment of tumors in the body and tail of the pancreas. Methods A retrospective analysis was performed on the medical records of 12 patients who underwent SPLDP at Fujian Provincial Hospital from October 2008 to December 2012 ; 11 cases had the spleen preserved by Kimnra method, and the other one had the spleen preserved by Warshaw method. Results All patients successfully underwent SPLDP without conversion to laparotomy. The mean operative time was 172.5 rain （ 120 -240 min） ; the mean intraoperative blood loss was 191.7 ml （50 -400 ml） ; the mean postoperative length of hospital stay was 9.5 days （4 -25 days）. Three patients had grade B pancreatic fistula after operation and were cured after adequate drainage. After operation, solid pseudopapillary tumor of the pancreas was pathologically confirmed in 4 cases, pancreatic neuroendocrine carcinoma in 2 cases, pancreatic islet cell tumor in 2 cases, pancreatic pseudocyst in 2 ca- ses, and pancreatic cystadenoma in 2 cases. The duration of postoperative follow -up was 6 -51 months, and no diabetes and tumor recur- rence were detected. Conclusion SPLDP is safe and feasible in the treatment of benign and low - grade malignant tumors in the body and tail of the pancreas.

关 键 词：腹腔镜检查 胰腺切除术 胰腺肿瘤 

分 类 号：R735.9[医药卫生—肿瘤]