保留脾脏在腹腔镜胰体尾切除术中的临床应用价值

The Value of Clinical Application of Laparoscopic Distal Pancreatectomy with Spleen-preserving

目的：探讨脾脏保留在腹腔镜胰体尾切除术中的临床应用价值。方法：回顾性分析我院肝胆外科12例腹腔镜下保留脾脏胰体尾切除术患者（LSPDP组）与14例脾脏切除术联合腹腔镜胰体尾切除术患者（LDPS组）的临床疗效差异。结果：11例LSPDP顺利完成,其中Kimura法9例,改行Warshaw法2例,手术成功率91.67%。14例LDPS顺利完成手术,手术成功率100.00%,两者比较差异无统计学意义（P〉0.05）。LSPDP组患者手术时间、住院时间均明显短于LDPS组,术中出血量明显低于LDPS组,两组患者比较差异具有统计学意义（P〈0.05）。两组患者术后并发症率与病理类型的比较差异无统计学意义（P〉0.05）。随访1-36个月未见复发。结论：保留脾脏在腹腔镜胰体尾切除术中具有重要的临床应用价值,具有微创、安全可行的优势。

Objective： To explore discuss the clinical value of laparoscopic distal pancreatectomy with spleen-preserving. Methods： To explore discuss the clinical value of laparoscopic distal pancreatectomy with spleen-preserving. Method： The different clinical effects of 12 cases of patients in laparoscopic distal pancreatectomy with spleen-preserving（ LSPDP group） and 14 cases of patients in laparoscopic distal pancreatectomy with splenctomy（ LDPS group） were retrospective analyzed. Results： 11 cases of patients in LSPDP group were successfully completed,including 9 cases in the method of Kimura and 2 cases in the diverted Warshaw. The success rate of operation was 91. 67%. 14 cases of patients in LDPS group were successfully completed. The success rate of operation was 100%. There was no statistically significant difference between the two groups（ P〈0. 05）. The operation time、postoperative hospital stay time in LSPDP group was obvious shorter than that in LDPS group. The blood loss in LSPDP group was obvious lower than that in LDPS group,there was statistically significant difference between the two groups（ P〈0. 05）. The rate of postoperative complications and the pathological type had no statistically significant difference between the two groups（ P〈0. 05）. No recurrence was observed after being followed up for 1-36 months. Conclusion： The laparoscopic distal pancreatectomy with spleen-preserving plays an important role in the clinical application,with the advantage of minimally invasiveness、safety and feasibility.