CAJ | 학술논문

目的比较不同方式腹腔镜胰腺远端切除术的安全性、可行性.方法 2005年9月至2012年10月,57例胰腺体尾部肿物患者接受腹腔镜胰腺远端切除术.根据手术方式将患者分为远端胰腺及脾切除组、保留完整脾动静脉的保脾远端胰腺切除组、不保留脾动静脉的保脾远端胰腺切除组及中转开腹组.记录4组患者术中情况(包括手术时间、术中出血量、输血量等)、术后恢复情况(包括术后住院天数、并发症发生率等)以及病理资料,并进行对比分析.结果 57例患者中,5例中转开腹,52例完成腹腔镜手术(其中1例为手助).保脾手术22例(39％),非保脾手术30例(61％).4组患者手术时间、术中出血量,术后住院时间差异均无统计学意义(均P＞0.05).无手术死亡病例,术后B级胰漏2例,无C级胰漏.结论不同术式的腹腔镜远端胰腺切除术均是安全的,应根据患者的具体情况选择不同术式.
목적 비교불동방식복강경이선원단절제술적안전성、가행성.방법 2005년9월지2012년10월,57례이선체미부종물환자접수복강경이선원단절제술.근거수술방식장환자분위원단이선급비절제조、보류완정비동정맥적보비원단이선절제조、불보류비동정맥적보비원단이선절제조급중전개복조.기록4조환자술중정황(포괄수술시간、술중출혈량、수혈량등)、술후회복정황(포괄술후주원천수、병발증발생솔등)이급병리자료,병진행대비분석.결과 57례환자중,5례중전개복,52례완성복강경수술(기중1례위수조).보비수술22례(39％),비보비수술30례(61％).4조환자수술시간、술중출혈량,술후주원시간차이균무통계학의의(균P＞0.05).무수술사망병례,술후B급이루2례,무C급이루.결론 불동술식적복강경원단이선절제술균시안전적,응근거환자적구체정황선택불동술식.
Objective To study the safety and feasibility of laparoscopic distal pancreatectomy in different modalities.Methods From September 2005 to October 2012,57 patients with masses located at pancreatic body/tail were treated by laparoscopic distal pancreatectomy.According to the operation procedure,patients were divided into four groups:distal pancreatectomy with splenectomy; Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein; spleen-preserving distal pancreatectomy and without conservation of the splenic artery and vein and laparoscopic to open distal pancreatectomy.Data of each group for operation time,blood loss and complications were collected and statistically analyzed.Results In 57 patients,5 cases were converted to open distal pancreatectomy.52 cases underwent successful laparoscopic operation (including 1 cases of hand-assisted).22 cases of spleen preserving operation (39％),and 30 cases of splenectomy operation (61％).Among the 4 groups of patients operation time,intraoperative blood loss,postoperative length of stay were not significantly different (all P ＞ 0.05).There was no operative mortality.Two cases suffered from B level postoperative pancreatic leakage,there was no C level pancreatic leakage.Conclusions Laparoscopic distal pancreatectomy with or without splenectomy is safe for the treatment of body and tail tumors of the pancreas.