Tang Yu, Tang Shanhong, Hu Sanyuan
Department of General Surgery, Qilu Hospital of Shandong University Jinan 250012, Shandong Province, China.
Department of Digestion, General Hospital of Chengdu Military Command Chengdu 610083, Sichuan Province, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):17128-39. eCollection 2015.
Spleen-preserving distal pancreatectomy can be performed with splenic vessel preservation (SPDP-SVP) or splenic vessel resection (SPDP-SVR). This meta-analysis aimed to evaluate the clinical outcomes of patients undergoing SPDP-SVP or SPDP-SVR.
A systematic literature search of PubMed, Embase, and the Cochrane Library was performed. The operative time, estimated blood loss, postoperative complications, pancreatic fistula (Grade B+C) rates, splenic infarction rates, gastric/perigastric varices rates and postoperative hospital stay were evaluated. RevMan 5.3 software was used to evaluate the differences between groups.
Nine studies involving 639 patients were included in this meta-analysis, of whom 402 underwent SPDP-SVP and 237 underwent SPDP-SVR. Patients who underwent SPDP-SVP had lower splenic infarction and gastric/perigastric varices rates. The operative time, estimated blood loss, postoperative complications, pancreatic fistula (Grade B+C) rates and postoperative hospital stays were comparable between these two groups.
SPDP-SVP and SPDP-SVR are both safe, feasible procedures for the management of benign or low-grade malignant pancreatic body or tail tumors. However, SPDP-SVR is related to higher incidence rates of early splenic ischemia and gastric/perigastric varices.
保留脾脏的胰体尾切除术可在保留脾血管（SPDP-SVP）或切除脾血管（SPDP-SVR）的情况下进行。本荟萃分析旨在评估接受SPDP-SVP或SPDP-SVR患者的临床结局。
对PubMed、Embase和Cochrane图书馆进行系统文献检索。评估手术时间、估计失血量、术后并发症、胰瘘（B+C级）发生率、脾梗死发生率、胃/胃周静脉曲张发生率和术后住院时间。使用RevMan 5.3软件评估组间差异。
本荟萃分析纳入了9项研究，共639例患者，其中402例行SPDP-SVP，237例行SPDP-SVR。接受SPDP-SVP的患者脾梗死和胃/胃周静脉曲张发生率较低。两组的手术时间、估计失血量、术后并发症、胰瘘（B+C级）发生率和术后住院时间相当。
SPDP-SVP和SPDP-SVR对于治疗良性或低度恶性胰体或胰尾肿瘤均是安全可行的手术。然而，SPDP-SVR与早期脾缺血和胃/胃周静脉曲张的较高发生率相关。
