Lee Seung Eun, Jang Jin-Young, Lee Kuhn Uk, Kim Sun-Whe
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2008 Dec;23(6):1011-4. doi: 10.3346/jkms.2008.23.6.1011. Epub 2008 Dec 24.
The spleen may be preserved during distal pancreatectomy (DP) for benign disease. The aim of this study was to compare the perioperative and postoperative courses of patients with conventional DP and spleen-preserving distal pancreatectomy (SPDP) for benign lesions or tumors with low-grade malignant potential occurred at the body or tail of the pancreas. A retrospective analysis was performed for the hospital records of all the patients undergoing DP and SPDP between January 1995 and April 2006. One-hundred forty-three patients underwent DP and 37 patients underwent SPDP. There were no significant differences in age, sex, indications of operation, estimated blood loss, operative time, and postoperative hospital stay between the two groups. Pancreatic fistula occurred in 21 (13.3%) patients following DP and in 3 (8.1%) following SPDP without a significant difference (p=0.081). Portal vein thrombosis occurred in 4 patients after DP. Splenic infarction occurred in one patient after SPDP. Overwhelming postosplenectomy infection was observed in one patient after DP. SPDP can be achieved with no increase in complication rate, operative time, or length of postoperative hospitalization as compared to conventional DP. Additionally, it has the advantage of reducing the risk of overwhelming postsplenectomy infection and postoperative venous thrombosis.
对于良性疾病，在胰体尾远端胰腺切除术（DP）期间可保留脾脏。本研究的目的是比较接受传统DP和保留脾脏的胰体尾远端胰腺切除术（SPDP）治疗胰腺体尾部良性病变或低级别恶性潜能肿瘤患者的围手术期和术后病程。对1995年1月至2006年4月期间所有接受DP和SPDP的患者的医院记录进行回顾性分析。143例患者接受了DP，37例患者接受了SPDP。两组患者在年龄、性别、手术指征、估计失血量、手术时间和术后住院时间方面无显著差异。DP术后21例（13.3%）患者发生胰瘘，SPDP术后3例（8.1%）患者发生胰瘘，差异无统计学意义（p = 0.081）。DP术后4例患者发生门静脉血栓形成。SPDP术后1例患者发生脾梗死。DP术后1例患者发生暴发性脾切除后感染。与传统DP相比，SPDP在不增加并发症发生率、手术时间或术后住院时间的情况下即可完成。此外，它具有降低暴发性脾切除后感染和术后静脉血栓形成风险的优势。
