保留脾脏的胰体尾切除术28例报告

Spleen-preserving distal pancreatectomy of benign lesions of pancreas:28 cases report

目的探讨保留脾脏的胰体尾切除术(SPDP)的可行性和手术技巧,比较SPDP与胰体尾、脾切除术(DP)患者的临床疗效。方法回顾性分析胰体尾切除术患者临床资料58例,其中DP30例(A组),SPDP28例(B组),B组又分为B1(保留脾血管组)和B2(合并脾血管切除组)两个亚组。比较两组在手术时间、术中出血量、术后并发症发生率及术后Α院时间的差异。结果 A、B组的手术时间、术中出血量、术后并发症发生率、胰瘘发生率、肺部感染发生率的组间差异均无统计学意义;SPDP组术后Α院时间明显较DP组短(P<0.05)。B1亚组较B2亚组手术时间明显延长(P<0.05);术中出血量、术后总的并发症发生率、胰瘘发生率、肺部感染发生率、术后Α院时间的差异无统计学意义。B1组与B2组的术后并发症发生率及术后Α院时间的差异无统计学意义。结论保留脾脏的胰体尾切除术不增加并发症发生率,而术后Α院时间缩短。保留脾血管㈦否对术后并发症发生率及术后Α院时间无影响。

Objective To evaluate the feasibility of spleen-preserving distal pancreatectomy（SPDP）.Meth-ods To analyze retrospectively 58 cases of distal pancreatectectomy performed from January 1999 to June 2009,including 30 patients had distal pancreatectomy with splenectomy（GroupA）,28 cases underwent spleen-preservation distal pancreatectomy（Group B）.Group B ineled splenic vessels preservation（Group B1）and splenic vessels re-section（Group B2）.The length of operation,intraoperative blood loss,incidence of perioperative complication and postoperative length of hospital stay were compared between Group A and Group B,Group B1 and Group B2.Re-sults The difference of length of operation,intraoperative blood loss,incidence of perioperative complication,pancreatic fistula,pneumonia were P0.05 in group A and group B.The postoperrative length of hospital stay in Group B was significantly less than that in Group A（P0.05）.The difference of length of operation in Group B1 was significantly more than that in Group B2（P0.05）.The difference of intraoperative blood loss,incidence of perioperative complication,pancreatic fistula,pneumonia,postoperrative length of hospital stay were P0.05 in the two groups.Conclusion SPDP of the benign lesions of the pancreas won＇t increase the possibility of compli-cation,and has a shorter postoperrative length of hospital stay.There is no statistic difference in incidence of pe-rioperative complication and postoperrative length of hospital stay between B1 and B2 subgroup.