保留脾血管的腹腔镜保留脾脏胰体尾切除术（LSPDP）：一种下后入路。
Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach.
作者信息
Hua Yong Fei, Yadav Dipesh Kumar, Bai Xueli, Liang Tingbo
机构信息
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009 Zhejiang, China.
Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Eastern Hospital, Medical School of Ningbo University, Ningbo, 315041 Zhejiang, China.
出版信息
Gastroenterol Res Pract. 2018 Sep 12;2018:1683719. doi: 10.1155/2018/1683719. eCollection 2018.
OBJECTIVE
To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility.
METHODS
Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups.
RESULTS
The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age ( = 0.18), sex ( = 0.56), preoperative diabetes ( = 1.00), ASA grading ( = 1.00), tumor size ( = 0.91), intraoperative blood loss ( = -0.01, = 0.99), hospital stay ( = -0.02, = 0.98), and pancreatic fistula rates ( = 1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time ( = -4.13, < 0.001) than the other approach group.
CONCLUSIONS
LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.
目的
总结经胰体下后入路保留脾血管的腹腔镜保留脾脏的远端胰腺切除术（LSPDP）的手术经验，并评估其可行性。
方法
本研究纳入2014年1月至2017年4月在宁波市李惠利医院和宁波市李惠利东部医院接受LSPDS的患者，并进行回顾性分析。根据手术入路将他们分为两组：下后入路组和其他入路组。我们试图比较两组的手术结果。
结果
49例患者成功完成LSPDP手术，48例患者的脾动脉和脾静脉得以保留，其中下后入路组26例，其他入路组22例。两组在年龄（=0.18）、性别（=0.56）、术前糖尿病（=1.00）、ASA分级（=1.00）、肿瘤大小（=0.91）、术中出血量（=-0.01，=0.99）、住院时间（=-0.02，=0.98）和胰瘘发生率（=1.00）方面无显著差异。下后入路行LSPDP的患者手术时间比其他入路组短（=-4.13，<0.001）。
结论
下后入路的LSPDS手术时间短，安全可行。
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