腹腔镜下胰体尾占位性病变切除16例体会

目的探讨胰体尾占位性病变行腹腔镜手术治疗的临床应用价值。方法回顾性分析自2014年开展腹腔镜胰腺手术以来成功完成的16例患者的临床资料。肿瘤直径1.0~12.6 cm,平均4.4 cm。行腹腔镜胰腺肿瘤摘除术4例,腹腔镜胰体尾脾切除术2例,腹腔镜胰体尾切除术10例。结果 16例患者均成功完成手术。手术时间90~330 min,平均210 min。术中平均出血量150ml。术后住院日4~28 d,平均11 d。术后病理回报黏液性囊腺瘤1例,浆液性囊腺瘤2例,胰岛素瘤5例,胰腺假性囊肿2例,实性假乳头状瘤2例,异位脾1例,自身免疫性胰腺炎1例,胰腺囊肿1例,胰腺癌1例。术后1例出现胰瘘,经通畅引流、抑酶对症治疗后痊愈;1例出现脾梗死,已随访1年,无临床症状及体征;1例出现结肠瘘,保守治疗痊愈。结论腹腔镜治疗胰体尾占位性病变是安全可行的。

Laparoscopic pancreatic resection for tumors in the body or tail of the pancreas: a report of 16 cases

Objective To summarize the clinical experiences and effects of laparoscopic pancreatic resection for tumors in the body or tail of the pancreas.Methods The clinical data of 16 cases who received laparoscopic distal pancreatic resection were retrospectively analyzed.The size of tumor were from 1.0-12.6 cm(arerage,4.4 cm).There were 4 cases of laparoscopic enucleation, 2 cases of laparoscopic distal pancreatectomy,10 cases of laparoscopic distal splenopancreatectomy.Results All operations were completed successfully with laparoscope.The operative time was 90-330 min(average,210 min).The intraoperative blood loss was 20-400 ml(average,150 ml).The hospital stay was 4-28 days(average,11 days).Postoperative pathologic results showed 1 case of pancreatic serous cystadenoma, 2 cases of pancreatic mucinous cystadenoma, 5 cases of insulinoma, 2 cases of pancreatic pseudocyst, 2 cases of solid pseudopapillary tumor, 1 case of heterotopic spleen, 1 case of autoimmune pancreatitis, 1 case of pancreatic cyst and 1 case of pancreatic adenocacinoma.The postoperative complications included 1 case of pancreatic fistula, 1 case of splenic infarction and 1 case of colonic fistula.All cases had no reoperation.Conclusions laparoscopic pancreatic resection for tumors in the body or tail of the pancreas.is feasible and safe.