论文部分内容阅读
目的探讨胰腺体尾部肿瘤进行保留脾脏和脾血管的胰体尾切除手术的可行性与安全性。方法对2003年12月至2005年1月收治的4例胰腺体尾部实性假乳头状肿瘤患者,采用了保留脾脏与脾血管的方法进行胰腺远端的切除。在肿瘤的右侧横断胰腺,显露脾动静脉,自胰腺的体部向脾脏方向分离脾动静脉血管与胰腺。不需离断脾动静脉和胃短血管,不需游离脾脏。结果4例患者均成功完成保留脾脏和脾血管的胰体尾切除手术。全部病例的平均手术时间为208min±52min;手术中的平均出血为475ml±96ml;手术均未需要输血;手术后平均住院时间为18d±13d。手术后1例患者出现胰瘘,经保守治疗治愈。无其他合并症。随访无复发与转移。结论保留脾脏和脾血管的胰腺远端切除是安全可行的,对于胰腺良性与交界性肿瘤的切除是最佳的选择。
Objective To investigate the feasibility and safety of pancreatic tail tail excision for preserving the spleen and splenic blood vessels in the pancreatic tail tumors. Methods From December 2003 to January 2005, 4 patients with solid pseudopapillary tumors of the pancreas were treated by splenectomy and splenic blood vessels for distal resection of the pancreas. On the right side of the tumor, the pancreas is transected, the splenic artery and veins are exposed, and splenic arteriovenous vessels and pancreas are separated from the body of the pancreas toward the spleen. Do not need to disconnect the splenic artery and stomach short blood vessels, without free spleen. Results All the 4 patients successfully completed the pancreatic body tail resection with spleen and splenic vessels preserved. The mean operation time was 208min ± 52min in all cases. The average bleeding during operation was 475ml ± 96ml. No blood transfusion was required in all cases. The average length of stay after operation was 18d ± 13d. One case of pancreatic fistula after surgery, cured by conservative treatment. No other complications. Follow-up without recurrence and metastasis. Conclusion It is feasible and safe to remove the distal pancreas of the spleen and splenic vessels, which is the best choice for the resection of benign and borderline tumors in the pancreas.