中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2015年
8期
673-676
,共4页
胰腺囊性肿瘤%保留脾脏的胰体尾切除术%腹腔镜检查
胰腺囊性腫瘤%保留脾髒的胰體尾切除術%腹腔鏡檢查
이선낭성종류%보류비장적이체미절제술%복강경검사
Pancreatic cystic neoplasm%Spleen-preserving distal pancreatectomy%Laparoscopy
目的 探讨腹腔镜保留脾脏和脾血管的胰体尾切除术治疗胰体尾囊性肿瘤的可行性.方法 回顾性分析2013年3月中山大学孙逸仙纪念医院收治的1例胰体尾囊性肿瘤患者的临床资料.术前结合患者一般情况及CT影像资料,制订保留脾脏和脾血管的腹腔镜胰体尾切除术为首选治疗方案,如术中脾血管难以与胰体尾充分游离或出现难以控制的出血,必要时转为腹腔镜或开腹联合胰体尾+脾脏切除术.术后每1～3个月门诊随访,随访时间截至2015年3月.结果 患者顺利完成保留脾脏和脾血管的腹腔镜胰体尾切除术.患者手术时间为192 min,术中出血量约50 mL.患者术后第1天即可下床活动,无术后并发症发生.术后病理学检查结果:胰腺多发微囊型浆液性囊腺瘤,最大直径为3.5 cm.术后第5天拔除引流管.术后第1、3、5天检测患者血清淀粉酶均正常.患者术后无出血、胰液漏、感染等并发症发生,患者于术后第8天出院.术后定期随访,腹上区隐痛不适症状无再发作.结论 保留脾脏和脾血管的腹腔镜胰体尾切除术治疗胰体尾囊性肿瘤具有创伤小、术后恢复快、保留了脾脏功能完整性等优势,值得推广应用.
目的 探討腹腔鏡保留脾髒和脾血管的胰體尾切除術治療胰體尾囊性腫瘤的可行性.方法 迴顧性分析2013年3月中山大學孫逸仙紀唸醫院收治的1例胰體尾囊性腫瘤患者的臨床資料.術前結閤患者一般情況及CT影像資料,製訂保留脾髒和脾血管的腹腔鏡胰體尾切除術為首選治療方案,如術中脾血管難以與胰體尾充分遊離或齣現難以控製的齣血,必要時轉為腹腔鏡或開腹聯閤胰體尾+脾髒切除術.術後每1～3箇月門診隨訪,隨訪時間截至2015年3月.結果 患者順利完成保留脾髒和脾血管的腹腔鏡胰體尾切除術.患者手術時間為192 min,術中齣血量約50 mL.患者術後第1天即可下床活動,無術後併髮癥髮生.術後病理學檢查結果:胰腺多髮微囊型漿液性囊腺瘤,最大直徑為3.5 cm.術後第5天拔除引流管.術後第1、3、5天檢測患者血清澱粉酶均正常.患者術後無齣血、胰液漏、感染等併髮癥髮生,患者于術後第8天齣院.術後定期隨訪,腹上區隱痛不適癥狀無再髮作.結論 保留脾髒和脾血管的腹腔鏡胰體尾切除術治療胰體尾囊性腫瘤具有創傷小、術後恢複快、保留瞭脾髒功能完整性等優勢,值得推廣應用.
목적 탐토복강경보류비장화비혈관적이체미절제술치료이체미낭성종류적가행성.방법 회고성분석2013년3월중산대학손일선기념의원수치적1례이체미낭성종류환자적림상자료.술전결합환자일반정황급CT영상자료,제정보류비장화비혈관적복강경이체미절제술위수선치료방안,여술중비혈관난이여이체미충분유리혹출현난이공제적출혈,필요시전위복강경혹개복연합이체미+비장절제술.술후매1～3개월문진수방,수방시간절지2015년3월.결과 환자순리완성보류비장화비혈관적복강경이체미절제술.환자수술시간위192 min,술중출혈량약50 mL.환자술후제1천즉가하상활동,무술후병발증발생.술후병이학검사결과:이선다발미낭형장액성낭선류,최대직경위3.5 cm.술후제5천발제인류관.술후제1、3、5천검측환자혈청정분매균정상.환자술후무출혈、이액루、감염등병발증발생,환자우술후제8천출원.술후정기수방,복상구은통불괄증상무재발작.결론 보류비장화비혈관적복강경이체미절제술치료이체미낭성종류구유창상소、술후회복쾌、보류료비장공능완정성등우세,치득추엄응용.
Objective To investigate the feasibility of spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy for the treatment of pancreatic cystic tumor of body and tail.Methods The clinical data of a female patient with pancreatic cystic tumor of body and tail who was admitted to the Sun Yat-Sen Memorial Hospital of the Sun Yat-Sen University in March 2013 were retrospectively analyzed.Spleen-and splenic vesselspreserving laparoscopic distal pancreatectomy was determined as the optimal therapeutic method according to the physical examination and the results of computered tomography scan.Laparoscopic or open operation combined with distal pancreatectomy and splenectomy would be carried out as a candidate choice once it is hard to separate the splenic artery and vein from distal pancreas or to control the serious vessels hemorrhage.The patient was followed up by outpatient examination every 1 to 3 months up to March 2015.Results Spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy was finished successfully.The operation time and volume of intraoperative blood loss were 192 minutes and 50 mL,respectively.The patient took out-of-bed for activity at postoperative day 1 without complications.The multiple severe microcystic pancreatic adenoma was confirmed by postoperative pathological examination,with a maximum diameter of 3.5cm.The leakage tube was removed at postoperative day 5.The levels of serum amylase at postoperative day 1,3,5 were normal.The patient was discharged at postoperative day 8 and got regular follow-up without bleeding,pancreatic fistula,infection and a symptom of epigastric pain or discomfort.Conclusion Spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy has advantages of less traumas,faster postoperative recovery and a preservation of normal splenic function,deserving clinical application.
