Tietze V, Schramm H, Hohmann U, Arnold S
Departement für Allgemeine, Viszerale und Kinderchirurgie des Chirurgischen Zentrums der Wald-Klinikum gGmbH Gera.
Zentralbl Chir. 2003 May;128(5):434-7. doi: 10.1055/s-2003-40041.
Chronic pancreatitis leads to changes of nearby organs with possible acute and chronic complications including lesions of the spleen. Among 341 patients operated upon between January 1981 and June 2002 in the surgical department Gera, we found 7 spontaneous spleen ruptures or such after minimal trauma and 4 pseudocysts, which expanded to the splenic hilus. In all cases splenectomy was carried out with resection of the tail of the pancreas with or without drainage of the pancreas. 2 patients with a history of splenectomy after minimal trauma underwent duodenum-preserving resection of the pancreatic head to Frey, and distal pancreatectomy, resp.
Lesions of the spleen belong to the rare complications of chronic pancreatitis. With known case history and mostly delayed course, the operative concept must be concentrated not only on the splenic lesion but also on the therapy of the chronic pancreatitis.
慢性胰腺炎会导致附近器官发生改变，可能出现急性和慢性并发症，包括脾脏病变。在1981年1月至2002年6月期间于 Gera 外科接受手术的341例患者中，我们发现7例自发性脾破裂或在轻微创伤后发生脾破裂，以及4例假性囊肿扩展至脾门。所有病例均行脾切除术，并根据情况切除胰尾，同时或不进行胰腺引流。2例有轻微创伤后脾切除史的患者分别接受了保留十二指肠的胰头 Frey 切除术和胰体尾切除术。
脾脏病变属于慢性胰腺炎的罕见并发症。鉴于病史已知且病程大多延迟，手术方案不仅要关注脾脏病变，还要注重慢性胰腺炎的治疗。
