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目的:探讨保留脾脏血管腹腔镜胰体尾切除术的可行性与安全性。方法:回顾分析2011年3月至2014年7月为38例患者行保留脾血管腹腔镜胰体尾部肿瘤手术的临床资料。结果:手术时间116~295 min,平均(170.5±50.2)min;术中失血量15~565 ml,平均(112.3±33.6)ml;均未输血。病理检查结果示胰腺导管腺癌11例,浆液性囊腺瘤6例,黏液性囊腺瘤9例,黏液性囊腺瘤局部癌变2例,胰岛素瘤4例,实性假乳头状肿瘤6例。术后3例发生胰漏,经保守治疗好转。余者术后均恢复顺利,无并发症发生,术后平均住院(7.36±2.13)d。结论:腹腔镜保留脾脏血管胰体尾切除术是有效治疗远端胰腺肿瘤的新术式,具有微创优势,安全、可行。
Objective: To investigate the feasibility and safety of preserving laparoscopic pancreatectomy for splenic vessels. Methods: A retrospective analysis of 38 cases of patients with splenic vascular laparoscopic pancreatic body tail tumor surgery in March 2011 to July 2014 clinical data. Results: The operative time ranged from 116 to 295 minutes (mean, 170.5 ± 50.2) min. The intraoperative blood loss ranged from 15 to 565 ml (mean, 112.3 ± 33.6) ml. Pathological examination showed pancreatic ductal adenocarcinoma in 11 cases, serous cystadenoma in 6 cases, mucinous cystadenoma in 9 cases, mucinous cystadenoma in 2 cases, insulinoma in 4 cases, solid pseudopapillary tumor in 6 cases . 3 cases of pancreatic leakage occurred after conservative treatment improved. The remaining patients recovered smoothly without complication and the average postoperative hospital stay was (7.36 ± 2.13) d. Conclusion: Laparoscopic splenic vessel preservation pancreatic tail resection is a new technique for the effective treatment of distal pancreatic tumors. It has the advantages of minimally invasive, safe and feasible.