腹腔镜保留脾脏的胰体尾切除术在临床上的应用评价

Evaluation on clinical application of laparoscopic spleen-preserving distal pancreatectomy

目的:探讨腹腔镜保留脾脏的胰体尾切除术(laparoscopic spleen--preserving distal pancreatectomy,LSPDP)在临床应用中的安全性和有效性。方法:回顾分析我院2008年10月至2014年10月23例腹腔镜胰体尾切除手术(laparoscopic distal pancreatectomy,LDP)病例,其中11例行腹腔镜胰体尾联合脾切除术(laparoscopic distal pancreatectomy with splenectomy,LDPS),12例行LSPDP。结果:23例手术均完全在腹腔镜下完成,未中转开腹,LDPS组与LSPDP组在手术时间(P=0.180)、术中出血量(P=0.494)、住院时间(P=0.459)、手术并发症(P=0.640)方面均无统计学差异;LDPS组术后白细胞计数稍高于LSPDP组[(10.1±3.4)vs.(9.8±2.3),P=0.647],LDPS组血小板较LSPDP组明显升高[(346.0±129.1)vs.(178.0±82.2),P=0.001]。结论:LSPDP在临床应用中,具有一定的安全性和可行性,可在未来临床实践中尝试并推广。

Objective：To investigate the safety and efficacy of laparoscopic spleen--preserving distal pancreatectomy（LSPDP） in clinical application. Methods：Clinical data of 23 patients undergoing laparoscopic distal pancreatectomy（LDP）in our hospital from October 2008 to October 2014 were retrospectively analyzed. Twelve patients underwent laparoscopic distal pancreatectomy with splenectomy（LDPS） while 11 underwent LSPDP. Results：Twenty-three cases of surgery were fully completed in the laparoscope.Operative time（P=0.180）,intraoperatve blood loss（P=0.494）,postoperative hospital stay（P=0.459）,and operative complication（P=0.640）were similar between LSPDP and LDPS groups. Blood cell count was slight higher in LDPS group than in LSPDP group[（10.1 ±3.4）vs.（9.8±2.3）,P=0.647];platelet count was significantly higher in LDPS groupin LSPDP group [（346.0 ±129.1） vs.（178.0±82.2）,P=0.001]. Conclusion：LSPDP shows safety and efficacy in clinical application and may attempt to practice and promote in the future.