胃双悬吊技术在腹腔镜保脾胰体尾切除术中的应用研究

Double gastric hanging in laparoscopic spleen-preserving distal pancreatectomy

目的:探讨在腹腔镜保脾胰体尾切除术中应用胃双悬吊技术的效果。方法:回顾分析2016年1月至2018年12月在昆明医科大学第二附属医院行腹腔镜保脾胰体尾切除术74例患者临床资料,其中男性23例,女性51例,年龄范围26~69岁,平均年龄46.7岁。根据术中是否采用胃双悬吊技术分为悬吊组( n=39)和对照组( n=35)。在腹腔镜保脾胰体尾切除术中悬吊组胃体、胃幽门处分别用自制橡皮吊带进行悬吊,自体外引出,对照组未悬吊。比较两组手术时间、术中出血量、输血、肿瘤最大径、切除胰腺长度、术后B/C级胰瘘、术后出血、术后住院时间等。 结果:两组患者性别、年龄、体质量指数、手术时间、输血、切除胰腺长度、术后B/C级胰瘘等比较,差异均无统计学意义(均 P>0.05)。悬吊组肿瘤最大径(3.7±0.8)cm,大于对照组(2.5±0.6)cm,术中出血量(130±20)ml、术后住院时间(8±3)d,少于对照组(250±20)ml、(16±5)d,差异均有统计学意义(均 P<0.05)。 结论:胃双悬吊技术应用于腹腔镜保脾胰体尾切除术中暴露效果满意,减少术中出血量和术后住院时间。

Objective To study the use of double gastric hanging in laparoscopic spleen-preserving distal pancreatectomy.Methods A retrospective analysis was conducted on the clinical data of 74 patients who underwent laparoscopic spleen-preserving distal pancreatectomy at the Second Affiliated Hospital of Kunming Medical University from January 2016 to December 2018.There were 23 males and 51 females,with age ranging from 26 to 69 years(average 46.7 years).The patients were divided into the suspension group(n=39)and the control group(n=35)according to whether the gastric double suspension technique was used during the operation.The gastric body and gastric pylorus in the suspension group were suspended by self-made rubber slings.These rubber slings were not used in the control group.The operative time,intraoperative blood loss,blood transfusion,tumor diameter,length of resected pancreas,postoperative pancreatic fistula grade B/C,postoperative bleeding and postoperative hospital stay were compared between the two groups.Results There were no significant differences between the two groups in gender,age,body mass index,operation time,blood transfusion rates,length of resected pancreas,and postoperative pancreatic fistula grade B/C(all P>0.05).The tumor diameter of the suspension group was(3.7±0.8)cm,which was significantly longer than that of the control group(2.5±0.6)cm.The intraoperative blood loss was(130±20)ml,and the postoperative hospital stay was(8±3)d,which were significantly less than those in the control group(250±20)ml,(16±5)d(all P<0.05).Conclusion The use of gastric double suspension technique in laparoscopic spleen-preserving pancreatic tail resection resulted in significantly reduced intraoperative blood loss and postoperative hospital stay.