保留脾血管的腹腔镜胰体尾切除术  

Laparoscopic distal pancreatectomy with preservation of the splenic vessels

作　　者：上官建营[1] 王湘辉[1] 范瑞芳[1] 项红军[1] 李红梅[1] 肖毅[1] 任彦顺[1] 袁克文[1] 

机构地区：[1]兰州军区总医院,甘肃兰州730050

出　　处：《腹腔镜外科杂志》2015年第2期127-130,共4页Journal of Laparoscopic Surgery

摘　　要：目的：探讨保留脾脏血管腹腔镜胰体尾切除术的可行性与安全性。方法：回顾分析2011年3月至2014年7月为38例患者行保留脾血管腹腔镜胰体尾部肿瘤手术的临床资料。结果：手术时间116~295 min,平均（170.5±50.2）min;术中失血量15~565 ml,平均（112.3±33.6）ml;均未输血。病理检查结果示胰腺导管腺癌11例,浆液性囊腺瘤6例,黏液性囊腺瘤9例,黏液性囊腺瘤局部癌变2例,胰岛素瘤4例,实性假乳头状肿瘤6例。术后3例发生胰漏,经保守治疗好转。余者术后均恢复顺利,无并发症发生,术后平均住院（7.36±2.13）d。结论：腹腔镜保留脾脏血管胰体尾切除术是有效治疗远端胰腺肿瘤的新术式,具有微创优势,安全、可行。Objective：To explore the clinical safety and validity of laparoscopic distal pancreatectomy with preservation of the splenic vessels. Methods：The clinical data of 38 patients who underwent laparoscopic distal pancreatectomy with preservation of the splenic vessels were retrospectively analyzed from Mar. 2011 to Jul. 2014. Results：The average operation time was（170. 5 ± 50. 2） min（range,116-295 min）,mean blood loss was（112. 3 ± 33. 6） ml（range,15-565 ml）,no blood transfusion occurred. Pathologic examination showed pancreatic ductal adenocarcinoma in 11 patients,serous cystadenoma in 6 patients,mucous cystadenoma in 9 patients,local canceration of mucous cystadenoma in 2 patients,insulinoma in 4 patients,solid pseudo-papillary tumor in 6 patients. Three patients with pancreatic leakage after operation relieved after conservative medical therapy. Others were uneventfully discharged from hospital without complications. The average postoperative hospital stay was（7. 36 ± 2. 13） d. Conclusions：Laparoscopic distal pancreatectomy with preservation of the splenic vessels is a new operation style with minimally invasive advantage,it is safe,feasible and effective in treatment of patients with distal pancreatic tumor.

关 键 词：胰腺肿瘤 胰腺切除术 腹腔镜检查 保留脾脏血管 

分 类 号：R735.9[医药卫生—肿瘤]