吊拉法在腹腔镜胰体尾切除术中的应用

Application of lasso technique for laparoscopic distal pancreatectomy

目的探讨吊拉法在腹腔镜胰体尾切除术中的临床应用价值。方法2005年9月-2009年9月上海交通大学医学院附属瑞金医院普外科共应用吊拉法施行腹腔镜胰体尾切除术14例。结果14例均手术成功,手术时间为120～360min,中位手术时间为222.5min,术中出血量为100～1200mL,中位出血量为300mL。术后住院时间为9～51d,中位住院时间为17d。术后发生胰漏1例,窦道出血1例,腹腔积液1例,均经保守治疗后痊愈。1例术后4个月发生切口疝。结论吊拉法可使术者在术中对胰腺的控制更为简便,从而减少对胰腺实质的损伤,提高手术安全性,是腹腔镜胰体尾切除的一种可行且值得推广的方法。

Objective To explore the clinical application of lasso technique for laparoscopic distal pancreatectomy. Methods From Sept. 2005 to Sept. 2009,14 patients underwent laparoscopic distal pancreatectomy by using lasso techinique in our department. Results The laparoscopic procedures were successfully completed in all the 14 cases, with an average operation time of 222.5 （ranging 120-360） min and a median intraoperative blood loss of 300 （ranging 100-1 200） mL. The mean postoperative hospitalization was 17 （ranging 9-51） days. There were one minor pancreatic leak, one sinus tract hemorrhage, and one pleural fluid collection; all of them were resolved conservatively. One patient experienced an incisional hernia 4 months after operation. Conclusion The lasso technique simplifies intraoperative manipulation of the pancreas during laparoscopic distal pancreatectomy, allowing for safe, gentle manipulation; it expands the indications for this approach to pancreatic resection; and the method is worth popularizing.