小儿腹腔镜保脾胰腺体尾部切除手术七例  

Experience of laparoscopic resection of spleen-preserving pancreatic body and tail in children

作　　者：尹强[1] 彭宇明 谢惟心 陈立建 袁妙贤[1] Yin Qiang;Peng Yuming;Xie Weixin;Chen Lijian;Yuan Miaoxian(Department of General Surgery,Hunan Children's Hospital,Changsha,Hunan 410007)

机构地区：[1]湖南省儿童医院普外科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2021年第7期627-630,共4页Journal of Clinical Pediatric Surgery

基　　金：湖南省卫健委课题项目(编号:C2019011)。

摘　　要：目的探讨儿童胰腺体尾部病变行保留脾脏和脾血管的腹腔镜胰体尾切除手术的可行性与安全性。方法以2015年1月至2020年12月湖南省儿童医院收治的7例胰腺体尾部实性假乳头状瘤患者为研究对象,7例均采用保留脾脏与脾动脉或脾动脉、脾静脉的方法切除胰腺体尾部,保留胰腺头颈部,保留脾脏和脾动脉、动静脉;2例保留脾脏和脾动脉。结果7例均成功完成保留脾脏和脾血管的胰体尾切除术,平均手术时间(150±56)min;术中平均出血量为(85±24)mL;术中无一例输血;术后平均住院时间(12±3)d。手术后1例出现胰瘘,经保守治疗痊愈,其他患者均无合并症,随访无一例复发与转移。结论保留脾脏和脾动脉的儿童胰腺体尾部切除手术安全可行,是否保留脾静脉取决于术中肿瘤与脾静脉的关系,儿童胰腺非恶性肿瘤部分切除术是最佳选择。Objective To investigate the feasibility and safety of laparoscopic resection of the body and tail of the pancreas in children with preservation of the spleen and splenic blood vessels.Methods Seven patients with solid pseudopapillary tumors of the pancreatic body and tail who were admitted to Hunan Children's Hospital from January 2015 to December 2020 were selected as the research objects.Seven patients were treated with the method of preserving the spleen and splenic artery or splenic artery and vein.Resection of the tail of the pancreas.The head and neck of the pancreas were preserved,and the body and tail occupied by the tumor were removed.The spleen and splenic arteries and veins were preserved in some cases,and the spleen and splenic arteries were preserved in some cases.Results All 7 cases successfully completed the resection of the body and tail of the pancreas with the preservation of the spleen and splenic vessels.The average operation time was(150±56)minutes;the average blood loss during the operation was(85±24)ml;none of the operations required blood transfusion;Hospitalization time is(12±3)days.Pancreatic fistula occurred in 1 case after the operation,which was cured by conservative treatment without other comorbidities.No recurrence or metastasis occurred in the follow-up.Conclusion The resection of the body and tail of the pancreas in children with the preservation of the spleen and splenic artery is safe and feasible.Whether the splenic vein is preserved depends on the relationship between the tumor and the splenic vein.Partial resection of non-malignant pancreatic tumors in children is the best choice.

关 键 词：胰腺肿瘤/外科学 腹腔镜检查/方法 治疗结果 儿童 

分 类 号：R735.9[医药卫生—肿瘤] R730.56[医药卫生—临床医学]