胰体尾局部病变患者腹腔镜保留脾脏的胰体尾切除术的可行性研究

目的探讨腹腔镜下保留脾脏的胰体尾切除术(LSPDP)的可行性与安全性。 方法回顾性分析2014年5月至2019年4月行腹腔镜下胰体尾切除术83例胰体尾局部病变患者，根据手术方法将行腹腔镜保留脾脏胰体尾切除术的35例患者设为LSPDP组，腹腔镜胰体尾联合脾脏切除术(LDPS)48例患者为LDPS组。数据采用SPSS24.0统计学软件分析，并发症发生率比较采用χ²检验；术中术后各项指标用( ±s)表示，采用独立样本t检验，以P<0.05为差异有统计学意义。 结果LSPDP组在术后首次排气时间优于LDPS组(P<0.05)，其余手术相关指标及术后恢复情况和并发症发生率的比较，差异均无统计学意义(P>0.05)。两组患者术后随访3～65个月，成功随访的80例患者均无肿瘤复发或转移或死亡病例。 结论腹腔镜下保留脾脏的胰体尾切除术与腹腔镜胰体尾联合脾脏切除术同样安全可行，且其具有保全脾脏功能的优势。

Feasibility study of laparoscopic distal pancreatectomy with preservation of the spleen in patients with local lesions in distal pancrea

Objective To study the feasibility and safety of laparoscopic distal pancreatectomy with preservation of the spleen.Methods 83 patients with local lesions in distal pancrea treated with laparoscopic distal pancreatectomy in our hospital from May 2014 to April 2019 were selected.According to the operation method,35 patients with laparoscopic spleen-preserving distal pancreatic resection were LSPDP group and 48 patients with laparoscopic distal pancreatic combined splenectomy were LDPS group.The data were analyzed by SPSS24.0 statistical software,Among them,the rate of complications and other counting data were expressed by n(%),and compared withχ^2,Measurement data such as operation time,intraoperative bleeding volume were expressed in (x±s),and compared with independent sample t test.P<0.05 indicated the difference was statistically significant.Results The first exhaust time of LSPDP group was better than that of LDPS group(P<0.05).There was no significant difference in other surgical related indicators,postoperative recovery and complications between the two groups(P>0.05).The patients in both groups were followed up for 3 to 65 months.No recurrence or metastasis of tumors or death was found in 80 patients who were followed up successfully.Conclusion Laparoscopic distal pancreatectomy with preservation of the spleen is as safe and feasible as laparoscopic pancreas body and tail combined with spleen resection,and it has the advantage of saving spleen function.