前后入路法行保留脾血管及脾脏的胰体尾切除术12例

目的探讨前后入路法行保留脾血管及脾脏的胰体尾切除术的可行性和安全性。方法回顾性分析2008年7月至2013年3月收治的12例胰体尾病变患者,采用前后入路法行保留脾血管及脾脏的胰体尾切除术。结果 12例患者均成功完成手术。手术时间180~280 min,平均（230±50）min。术中出血量240~360 ml,平均（300±60）ml,术中均未输血。术后平均住院时间（12±2）d。术后胰瘘1例,引流量20~60 ml/d,经引流后治愈,无其他并发症。术后随访6~30个月,无一例死亡。结论在掌握脾动静脉的解剖基础上,采用前后入路法耐心、细致分离脾动静脉,保留脾血管及脾脏的胰体尾切除术安全、简便,易于实施,值得推广。

Clinical application of anterior and posterior approaches for distal pancreatectomy with spleen and the splenic vessels preserved

Objective To investigate the feasibility and safety of anterior and posterior approaches for distal pancreatectomy with spleen and the splenic vessels preserved. Methods Twelve patients of benign diseases of distal pancreas admitted in Taizhou People＇s Hospital from July 2008 to March 2013 were given anterior and posterior distal pancreatectomy with spleen and the splenic vessels preserved. Results All patients underwent the operation successfully. The mean operation time was（230±50） minutes. The blood loss was 240-360 ml with a mean of（300±60） ml. No patients needed blood transfusion during the operation. The mean length of post-operative hospital stay was（12±2） days. One patient developed pancreatic fistula and was cured with non-operative management; there was no other complications. All patients were followed up for 6 to 30 months,and there was no death. Conclusion On the basis of mastering the anatomy of splenic artery and vein,anterior and posterior approaches are safe and convenient in performing distal pancreatectomy with spleen and the splenic vessels preserved.