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孤立性钝性胰腺创伤中行保留脾脏的胰体尾部切除术。

Spleen preserving distal pancreatectomy in an isolated blunt pancreatic trauma.

机构信息

Alexandre Zanchenko Fonseca, Marcelo Augusto Fontenelle Ribeiro Jr, Orlando Contrucci, Alexandre Pompeo, Adriana Orsetti, Herico Arsie Neto, Department of General Surgery, University of Santo Amaro, São Paulo-SP, CEP 04601-060, Brazil.

出版信息

World J Gastrointest Surg. 2011 Sep 27;3(9):138-41. doi: 10.4240/wjgs.v3.i9.138.

Abstract

Blunt isolated pancreatic trauma is uncommon, accounting for 1%-4% of high impact abdominal injuries. In addition, its diagnosis can be difficult; physical signs may be poor and laboratory findings nonspecific, resulting in delayed treatment. Preserving the spleen during distal pancreatectomy (DP) is controversial. One of the spleen's functions regards immunity; complications following splenectomy include leukocytosis, thrombocytosis, overwhelming post splenectomy sepsis and some degree of immunodeficiency. This is why many authors favor its preservation. We describe a case of a young man with an isolated pancreatic trauma due to a blunt abdominal trauma with a delayed presentation who was treated with spleen-preserving DP and we discuss the value of this procedure with reference to the literature.

摘要

钝性孤立性胰腺外伤并不常见,占高能量腹部损伤的 1%-4%。此外,其诊断可能较为困难;体征可能不佳,实验室检查结果也不特异,导致治疗延误。在胰体尾切除术(DP)中保留脾脏存在争议。脾脏的功能之一是免疫;脾切除术后的并发症包括白细胞增多、血小板增多、脾切除术后感染性休克和一定程度的免疫缺陷。这就是为什么许多作者赞成保留脾脏。我们描述了一例因钝性腹部外伤导致孤立性胰腺外伤的年轻患者,其表现延迟,采用保留脾脏的 DP 治疗,我们结合文献讨论了该手术的价值。

相似文献

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Spleen-preserving distal pancreatectomy in trauma.创伤性脾保留远端胰腺切除术
J Trauma Acute Care Surg. 2018 Jan;84(1):118-122. doi: 10.1097/TA.0000000000001725.

本文引用的文献

1
Spleen and gastrosplenic ligament preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy.
J Hepatobiliary Pancreat Surg. 2009;16(6):792-5. doi: 10.1007/s00534-009-0113-7. Epub 2009 Apr 24.
2
Management strategies in isolated pancreatic trauma.
J Hepatobiliary Pancreat Surg. 2009;16(2):189-96. doi: 10.1007/s00534-009-0042-5. Epub 2009 Feb 13.
10
Management of blunt major pancreatic injury.钝性严重胰腺损伤的处理
J Trauma. 2004 Apr;56(4):774-8. doi: 10.1097/01.ta.0000087644.90727.df.

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