Tagaya N, Ishikawa K, Kubota K
Second Department of Surgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Surg Endosc. 2002 Jan;16(1):217-8. doi: 10.1007/s004640041021. Epub 2001 Nov 12.
We report a successful spleen-preserving laparoscopic distal pancreatectomy for a large insulinoma with conservation of the splenic artery and vein. The patient was a 48-year-old man with syncope due to hypoglycemia. Abdominal computed tomography (CT) and ultrasonography revealed a large 6-cm mass located in the tail of the pancreas. We adopted the laparoscopic approach to remove the tumor. After careful dissection and an accurate hemostasis between the pancreas and splenic vessels, laparoscopic distal pancreatectomy was carried out using a linear stapler. There were no perioperative complications. The patient was discharged uneventfully. He had no hypoglycemic episodes or abdominal symptoms during 8 months of follow-up. When performed by experienced laparoscopic surgeons in conjunction with intraoperative ultrasonography, spleen-preserving laparoscopic distal pancreatectomy with conservation of the splenic artery and vein is a technically feasible procedure for the treatment of benign lesions of the tail or body of the pancreas.
我们报告了一例成功的保留脾脏的腹腔镜远端胰腺切除术，用于治疗一个大的胰岛素瘤，同时保留了脾动脉和脾静脉。患者为一名48岁男性，因低血糖而晕厥。腹部计算机断层扫描（CT）和超声检查显示胰腺尾部有一个6厘米的大肿块。我们采用腹腔镜方法切除肿瘤。在胰腺和脾血管之间仔细解剖并精确止血后，使用线性切割吻合器进行腹腔镜远端胰腺切除术。围手术期无并发症。患者顺利出院。在8个月的随访期间，他没有低血糖发作或腹部症状。当由经验丰富的腹腔镜外科医生结合术中超声进行时，保留脾脏并保留脾动脉和脾静脉的腹腔镜远端胰腺切除术是治疗胰腺尾部或体部良性病变的一种技术上可行的手术。
