不同入路的胰体尾脾脏切除术近期疗效分析

目的探讨胰体尾脾脏切除的手术入路。方法回顾性分析我院2007年至2008年行胰体尾脾脏切除术36例患者的临床资料,其中16例采用逆行入路,20例采用常规入路。结果所有患者均成功完成逆行性胰体尾切除术,逆行入路组平均手术时间（80±14）min,术中平均出血150ml,患者术后恢复良好,术后平均住院时间（11±3.5）d,无胰漏及其他并发症发生。常规入路组平均手术时间（120±23）min,术中平均出血210ml,均未输血,患者术后恢复良好,术后平均住院时间（13±4.1）d,无胰漏及其他并发症发生,无新发糖尿病病例。对所有患者随访3～24个月,有2例分别存活6个月和11个月,其余患者健在。结论逆行入路胰体尾脾脏切除易控制门静脉、肠系膜上静脉,降低了门静脉、肠系膜上静脉脾脏动静脉损伤的可能;易控制脾脏动静脉,减少了出血量,降低了手术难度,缩短了手术时间,同时降低了肿瘤复发或转移的机会。

Analysis of short-term therapeutic efficacy of resection of body and tail of pancreas and spleen by two approaches

Objective To investigate the approach of resection of body and tail of pancreas and spleen. Methods Thirty-six patients received resection of body and tail of pancreas and spleen between 2007-2008. Of them, 16 received operation by regrade approach, 20 were operated by routine approach. Results All the patients received operation without complication,the mean operation time by retrograde approach was （ 80 ± 14 ） rain, the mean volume of bleeding was 150 ml and the mean length of hospital stay was （ 11 ± 3.5 ） d. The mean operation time by routine approach was （ 120 ± 23 ） min, the mean volume of bleed- ing was 210 ml and the mean length of hospital stay was （13 ±4. 1 ）d. The operation time, mean volume of bleeding, and the mean length of hospital stay were significantly different between the two groups. Conclusion Resection of body and tail of pancreas and spleen by retrograde approach is much more easy and safe than by routine approach.