腹腔镜下胰体尾切除术及胰腺假性囊肿内引流术治疗经验

Laparoscopic distal pancreatectomy and transgastric drainage of pancreatic pseudocyst

目的总结腹腔镜下胰体尾切除术及胰腺假性囊肿内引流术的治疗经验,探讨腹腔镜下胰体尾部手术的可行性。方法2005年2月～2006年8月分别对1例胰体尾囊性占位、2例胰岛素瘤患者施行腹腔镜下胰体尾切除术(保留脾脏1例);对1例胰体尾部假性囊肿患者施行腹腔镜下胰腺假性囊肿-胃吻合内引流术。结果4例手术均获成功,术中出血量均在200mL以内,手术时间分别为150、210、240和120min,4例患者术后恢复顺利,术前症状明显缓解,无并发症发生。2例胰岛素瘤患者术后血糖恢复。胰腺假性囊肿患者内引流术后囊肿明显缩小。结论腹腔镜下胰体尾切除术及胰腺囊肿内引流术是安全可行的,具有创伤小、恢复快及并发症少等优点。

[Objective] To summarize the experience of laparoscopic distal pancreatectomy and transgastric drainage of pancreatic pseudoeyst and discuss the feasibility of laparoscopic distal pancreatic surgery. [Methods] From Feb 2005 to Aug 2006, 1 patient with cystic lesion in the body and tail of pancrease and 2 patients with insulinomas underwent laparoscopic distal pancreatectomy （preservation of spleen in 1 patient）, 1 patient with pseudocyst in the body and tail of pancrease underwent laparoscopic transgastric drainage. [Results] All the 4 operations were successful with the blood loss less than 200 mL and the operative time were 150, 210, 240 and 120 min respectively. All the patients＇ symptoms disappeared after operation without postoperative complication. The blood sugar increased to normal and the pancreatic pseudoeyst decreased in size. [Conclusions] Laparoscopic distal pancreatectomy and transgastric drainage of pancreatic pseudocyst are safe and feasible for the management of benign tumor and pseudocyst in the body and tail of pancrease with the advantage of less injury, earlier recovery and fewer complications.