Pais-Costa Sergio Renato, Sousa Guilherme Costa Crispim de, Araujo Sergio Luiz Melo, Lima Olímpia Alves Teixeira
Hospital Santa Lúcia, Brasília, DF.
Hospital Brasília, Brasília, DF, Brasil.
Arq Bras Cir Dig. 2018 Aug 16;31(3):e1395. doi: 10.1590/0102-672020180001e1395.
Laparoscopic distal pancreatectomy has been the choice for resection of distal pancreas lesions due many advantages over open approach. Spleen preservation technique seems minimizes infectious complications in long-term outcome.
To present the results of laparoscopic distal pancreatectomies with spleen preservation by Kimura´s technique (preservation of spleen blood vessels) performed by single surgical team.
Retrospective case series aiming to evaluate both short and long-term outcomes of laparoscopic distal pancreatectomies with spleen preservation.
A total of 54 laparoscopic distal pancreatectomies were performed, in which 26 were laparoscopic distal pancreatectomies with spleen preservation by Kimura´s technique. Mean age was 47.9 years-old (21-75) where 61.5% were female. Mean BMI was 28.5 kg/m² (18-38.8). Mean diameter of lesion was 4.3 cm (1.8-7.5). Mean operative time was 144.1 min (90-200). Intraoperative bleeding was 119.2 ml (50-600). Conversion to laparotomy 3% (n=1). Postoperative morbidity was 11.5%. Postoperative mortality was null. Mean of hospital stay was 4.8 days (2-14). Mean time of follow-up period was 19.7 months (2-60). There was no neoplasm recurrence or mortality on evaluated period. There was no infectious complication.
Laparoscopic distal pancreatectomy with spleen and splenic vessels preservation is feasible, safe, and effective procedure. This technique presented both low morbidity and null mortality on this sample. There were neither infectious complications nor neoplasm recurrence on long-term follow-up period.
由于与开放手术相比具有许多优势，腹腔镜远端胰腺切除术已成为切除胰腺远端病变的首选方法。保留脾脏技术似乎能将长期结果中的感染性并发症降至最低。
介绍由单一手术团队采用木村技术（保留脾脏血管）进行的腹腔镜保留脾脏远端胰腺切除术的结果。
回顾性病例系列研究，旨在评估腹腔镜保留脾脏远端胰腺切除术的短期和长期结果。
共进行了54例腹腔镜远端胰腺切除术，其中26例采用木村技术保留脾脏的腹腔镜远端胰腺切除术。平均年龄为47.9岁（21 - 75岁），女性占61.5%。平均体重指数为28.5 kg/m²（18 - 38.8）。病变平均直径为4.3 cm（1.8 - 7.5）。平均手术时间为144.1分钟（90 - 200分钟）。术中出血119.2毫升（50 - 600毫升）。中转开腹率为3%（n = 1）。术后发病率为11.5%。术后死亡率为零。平均住院时间为4.8天（2 - 14天）。平均随访时间为19.7个月（2 - 60个月）。在评估期间无肿瘤复发或死亡。无感染性并发症。
保留脾脏和脾血管的腹腔镜远端胰腺切除术是一种可行、安全且有效的手术。该技术在本样本中发病率低且死亡率为零。长期随访期间既无感染性并发症也无肿瘤复发。
