Laparoscopic distal pancreatectomy: Up-to-date and literature review

Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffu- sion. Additional researches are necessary to determine the best technique to improve the procedure results.

胰肠捆绑式吻合预防胰瘘15例报告

目的 为了预防胰肠吻合术后胰瘘的发生 ,按照彭淑牖教授设计的胰肠捆绑式吻合法进行胰肠吻合。方法 游离胰腺断端3～4cm ,胰管内置硅胶管 ,两者用丝线固定 ,空肠3～4cm处断端用石炭酸破坏其粘膜 ,胰断端套入该空肠内3～4cm ,空肠断端与就近胰包膜缝合1周 ,最后距空肠断面约1cm及2cm处各用粗丝线环绕空肠壁捆绑二道 ,使空肠壁与胰腺紧密相贴。结果 经过连续15例临床应用均未发生胰瘘 ,恢复顺利。结论 本法操作方便 ,简单 ,是胰肠吻合理想的手术方式 ,值得推广。