Dai Meng-hua, Zhao Yu-pei, Liao Quan, Liu Zi-wen, Guo Jun-chao, Cong Lin
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Wai Ke Za Zhi. 2006 Aug 1;44(15):1022-5.
To evaluate the safety, feasibility indications, prognosis and follow-up of laparoscopic distal pancreatectomy.
Retrospective study was employed on 10 patients collected from Feb. to Oct. 2005 with diagnosis of masses located at pancreatic body/tail. The mean age was 43 years and ratio between male and female was 1:9. Preoperative diagnosis: nine patients with cystic lesion located at pancreatic body and tail, one patient with pancreatic endocrine tumor with liver metastasis, which located at pancreatic tail. The mean size of the tumor was 4.0 cm. All patients received adjuvant examinations including CT contrast scan, abdominal ultrasound or endoscopic ultrasound. The serum levels of tumor markers (including CA19-9, CA242, CA50 and CEA) of the patients were all normal.
All patients received distal pancreatectomy by laparoscope successfully. Among them, seven procedures were spleen-preserved and three with splenectomy. Mean operative time was 228 +/- 26 min, and mean blood lose volume was 173 +/- 100 ml. One patient suffered with pancreatic fistula after operation but was successfully managed by conservative therapy in one month, pancreatic pseudocyst was detected in one patient and disappeared spontaneously in one month, no other morbidity occurred. The postoperative hospital stay was 12 - 16 d (mean, 13.5 d). The serum glucoses of 10 patients after operation were normal. The mean time of follow-up was 8 months (2 - 22 months). During the follow-up, nine patients with benign cystic lesions did not relapse. And the other one patient with malignant metastasis kept stable, not recurrence was detected in one year after operation.
Laparoscopic distal pancreatectomy was safe and feasible for benign cystic tumors located at the body or tail of the pancreas.
评估腹腔镜胰体尾切除术的安全性、可行性、适应证、预后及随访情况。
对2005年2月至10月收集的10例诊断为胰体/胰尾肿块的患者进行回顾性研究。平均年龄43岁，男女比例为1:9。术前诊断：9例为胰体尾囊性病变，1例为胰尾内分泌肿瘤伴肝转移。肿瘤平均大小为4.0 cm。所有患者均接受了包括CT增强扫描、腹部超声或内镜超声在内的辅助检查。患者的肿瘤标志物（包括CA19-9、CA242、CA50和CEA）血清水平均正常。
所有患者均成功接受了腹腔镜胰体尾切除术。其中，7例保留脾脏，3例切除脾脏。平均手术时间为228±26分钟，平均失血量为173±100毫升。1例患者术后发生胰瘘，但经保守治疗1个月后成功治愈，1例患者检测到胰腺假性囊肿，1个月后自行消失，未发生其他并发症。术后住院时间为12 - 16天（平均13.5天）。10例患者术后血糖均正常。平均随访时间为8个月（2 - 22个月）。随访期间，9例良性囊性病变患者未复发。另1例有恶性转移的患者病情稳定，术后1年未检测到复发。
腹腔镜胰体尾切除术对于位于胰体或胰尾的良性囊性肿瘤是安全可行的。
