全腹腔镜下远端胰腺切除术治疗外观良性肿瘤：一例报告
Total laparoscopic distal pancreatectomy for a benign appearing tumor: a case report.
作者信息
Kosmidis Christopher, Efthimiadis Christopher, Anthimidis George, Grigoriou Marios, Toulis Evangelos, Levva Sofia, Prousalidis Ioannis, Fachantidis Epaminondas
机构信息
Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, 57 001 Pylaia, Thessaloniki, Greece.
出版信息
Cases J. 2009 Jul 22;2:8468. doi: 10.4076/1757-1626-2-8468.
INTRODUCTION
Therapeutic laparoscopy of the pancreas is still described as experimental surgery by many surgeons. Many issues remain to be clarified in determining the future of this new method.
CASE PRESENTATION
The objective of the present study was to present a case of a patient who underwent totally laparoscopic distal pancreatectomy for a benign appearing tumor in the tail of the pancreas and to critically discuss the treatment of the pancreatic remnant and the need to perform splenectomy with or without ligation of the splenic vessels.
CONCLUSION
Laparoscopic distal pancreatectomy is usually performed en-bloc along with resection of the spleen, for technical reasons, making the operation short and easy. However, it should only be performed in centers with expertise in both pancreatic surgery and advanced laparoscopy. Furthermore, the use of linear stapler to cut the pancreas (4.5-mm staples) seems to prevent fistula formation and ischemia of the pancreatic stump.
引言
许多外科医生仍将胰腺治疗性腹腔镜手术描述为实验性手术。在确定这种新方法的未来方面，仍有许多问题有待阐明。
病例报告
本研究的目的是介绍一例患者，该患者因胰腺尾部出现良性肿瘤接受了全腹腔镜远端胰腺切除术，并对胰腺残端的处理以及是否需要在结扎或不结扎脾血管的情况下进行脾切除术进行批判性讨论。
结论
出于技术原因，腹腔镜远端胰腺切除术通常与脾脏切除术一并整块进行，使手术简短且容易。然而，它应该只在具备胰腺手术和高级腹腔镜技术专业知识的中心进行。此外，使用线性缝合器切割胰腺（4.5毫米缝合钉）似乎可以预防胰瘘形成和胰腺残端缺血。
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