Okuno Masataka, Shimizu Yasuhiro, Senda Yoshiki, Natsume Seiji, Kawakatsu Shoji, Ito Seiji, Komori Koji, Abe Tetsuya, Misawa Kazunari, Ito Yuichi, Kinoshita Takashi, Higaki Eiji, Fujieda Hironori, Sato Yusuke, Ouchi Akira, Nagino Masato, Hara Kazuo
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan.
J Surg Case Rep. 2022 Apr 3;2022(4):rjac088. doi: 10.1093/jscr/rjac088. eCollection 2022 Apr.
There are two techniques for a spleen-preserving distal pancreatectomy (SPDP): SPDP with splenic vessel preservation, and SPDP with splenic vessel resection. In some cases, although the splenic artery (SpA) can be preserved, the splenic vein (SpV) must be resected. We report the short- and long-term outcomes of three patients who underwent a new technique of laparoscopic SPDP with SpA preservation and SpV resection (SPDP-VRes). A grade B pancreatic fistula, which occurred in two patients, was successfully treated with drainage tube management. In all cases, the omental branches of the left gastroepiploic vein functioned as a drainage vein, and there was no splenomegaly, thrombocytopenia, or varix formation during the follow-up period (19 months to 5 years). Patients undergoing laparoscopic SPDP-VRes had no severe complications during the follow-up period; preserving the left omental branch is a key to this procedure. Laparoscopic SPDP-VRes might be a useful treatment option for patients undergoing SPDP.
保留脾脏的远端胰腺切除术（SPDP）有两种技术：保留脾血管的SPDP和切除脾血管的SPDP。在某些情况下，尽管脾动脉（SpA）可以保留，但脾静脉（SpV）必须切除。我们报告了3例行保留SpA并切除SpV的腹腔镜SPDP新技术（SPDP-VRes）患者的短期和长期结果。2例患者发生的B级胰瘘通过引流管处理成功治愈。在所有病例中，胃网膜左静脉的网膜分支起到引流静脉的作用，随访期间（19个月至5年）均未出现脾肿大、血小板减少或静脉曲张形成。接受腹腔镜SPDP-VRes的患者在随访期间未出现严重并发症；保留左网膜分支是该手术的关键。腹腔镜SPDP-VRes可能是接受SPDP患者的一种有用治疗选择。
