Khirallah Mohammad Gharieb, Salama Fouad Hesham, Arafa Mohammad Ahmad, Eldessoki Nagi Ebrahim, Elshanshory Mohammad
Department of Pediatric Surgery, Hematology and Oncology, Tanta University, Tanta, Egypt.
Department of Pediatric, Hematology and Oncology, Tanta University, Tanta, Egypt.
J Indian Assoc Pediatr Surg. 2019 Jul-Sep;24(3):180-184. doi: 10.4103/jiaps.JIAPS_64_18.
Laparoscopic splenectomy (LS) became the standard choice for splenectomy in children with benign hematological disease. There are few reports about pancreatic injury during LS. The purpose of this study is to spot on factors increasing the risk of pancreatic injury during LS in children.
A total of 140 children had LS for benign causes. Children were categorized into A and B groups. LigaSure™ was used to control pedicle in Group A, while endoscopic staplers were used in Group B. Preoperative levels of amylase, lipase, and lactate dehydrogenase (LDH) were obtained. The mean of pancreatic enzymes and LDH values was calculated on the 3 postoperative successive days.
A total of 71 boys and 69 girls had LS. The mean splenic size was 13.50 cm in Group A and 12.51 cm in Group B. The mean operative time in Group A was 41.91 min and in Group B was 56.36 min. The mean level of amylase was 42.99 IU/ml in Group A and 75.70 IU/ml in Group B ( = 0.001). The mean level of lipase was 37 IU/ml in Group A and 76.66 IU/ml in Group B ( = 0.001).
Pancreatic injury during LS is a rare complication usually presented on biochemical level. We believe that it is a hemostatic-dependent complication rather than splenic size or nature of disease.
腹腔镜脾切除术（LS）已成为患有良性血液系统疾病儿童脾切除术的标准选择。关于LS术中胰腺损伤的报道较少。本研究的目的是找出增加儿童LS术中胰腺损伤风险的因素。
共有140名儿童因良性病因接受了LS。将儿童分为A组和B组。A组使用LigaSure™控制脾蒂，而B组使用内镜吻合器。获取术前淀粉酶、脂肪酶和乳酸脱氢酶（LDH）水平。在术后连续3天计算胰腺酶和LDH值的平均值。
共有71名男孩和69名女孩接受了LS。A组脾平均大小为13.50 cm，B组为12.51 cm。A组平均手术时间为41.91分钟，B组为56.36分钟。A组淀粉酶平均水平为42.99 IU/ml，B组为75.70 IU/ml（P = 0.001）。A组脂肪酶平均水平为37 IU/ml，B组为76.66 IU/ml（P = 0.001）。
LS术中胰腺损伤是一种罕见的并发症，通常在生化水平上表现出来。我们认为这是一种依赖止血的并发症，而非脾大小或疾病性质所致。
