• 1.溫州醫(yī)學(xué)院附屬第一醫(yī)院肝膽外科(浙江溫州 325000);;
  • 2.溫州市第二人民醫(yī)院腫瘤外科(浙江溫州 325000);;
  • 3.上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院普外科(上海 200092);;
  • 4.揚(yáng)州市第一人民醫(yī)院普外科(江蘇揚(yáng)州 225200);

目的研究保留脾臟的胰體尾切除術(shù)（SpDP）的可行性、安全性，探討其選擇及具體方法。方法對(duì)上海交通大學(xué)附屬新華醫(yī)院2004年1月至2007年12月期間施行的7例SpDP患者的臨床資料進(jìn)行回顧性分析。結(jié)果6例成功施行保留脾血管的SpDP，1例成功施行部分脾血管切除的SpDP，手術(shù)時(shí)間（2.93±0.38） h，術(shù)中失血量為（392.86±109.65） ml。術(shù)后發(fā)生胰瘺1例，經(jīng)保守治療后好轉(zhuǎn)出院。全組患者術(shù)后血小板計(jì)數(shù)最高值為（273±43.76）×109/L，術(shù)后住院時(shí)間為（17.86±8.07） d，住院期間無死亡病例。6例腫瘤患者術(shù)后隨訪(49.2±14.4)個(gè)月（30～70個(gè)月），未見腫瘤復(fù)發(fā)、轉(zhuǎn)移征象。結(jié)論SpDP是一種安全、可行的術(shù)式，對(duì)于胰體尾良性占位等合適的病例有一定的臨床應(yīng)用價(jià)值。

引用本文： 吳向嵩,陳德琴,吳文廣,柳詠,劉穎斌. 保留脾臟的胰體尾切除術(shù)的選擇與方法. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(1): 17-20. doi: 復(fù)制

1. Warshaw AL. Conservation of the spleen with distal pancreatectomy [J]. Arch Surg, 1988, 123(5): 550553.
2. 代文杰, 姜洪池, 喬海泉. 保留脾臟的胰體尾切除術(shù) [J]. 中國實(shí)用外科雜志, 2001, 21(4): 245247.
3. 甄作均, 王峰杰. 胰體尾部腫瘤手術(shù)切除的相關(guān)問題 [J]. 實(shí)用醫(yī)學(xué)雜志, 2010, 26(10): 16811683.
4. 謝敏, 王健, 包善華, 等. 保脾胰體尾切除術(shù)在胰體尾病變時(shí)的應(yīng)用 [J]. 現(xiàn)代醫(yī)學(xué), 2009, 37(4): 308309.
5. 劉吉寶, 郭予, 魏毓龍. 20例胰體尾癌的外科治療體會(huì) [J]. 醫(yī)學(xué)論壇雜志, 2006, 27(14): 4445.
6. 翟剛, 李強(qiáng). 保留脾臟的胰體尾癌切除術(shù)18例 [J]. 腫瘤研究與臨床, 2009, 21(8): 482483.
7. 劉騫, 邵永孚, 王成峰, 等. 保留脾臟的胰體尾癌切除14例分析 [J]. 中華肝膽外科雜志, 2005, 11(4): 248249.
8. Shoup M, Conlon KC, Klimstra D, et al. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? [J]. J Gastrointest Surg, 2003, 7(8): 946952.
9. 邱應(yīng)和, 劉也夫, 姜小清, 等. 胰體尾癌的外科治療 [J]. 中華胰腺病雜志, 2008, 8(4): 272273.
10. Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients [J]. Ann Surg, 1999, 229(5): 693700.
11. Benoist S, Dugué L, Sauvanet A, et al. Is there a role of preservation of the spleen in distal pancreatectomy? [J]. J Am Coll Surg, 1999, 188(3): 255260.
12. Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy [J]. Arch Surg, 2002, 137(2): 164168.
13. Carrère N, Abid S, Julio CH, et al. Spleenpreserving distal pancreatectomy with excision of splenic artery and vein: a casematched comparison with conventional distal pancreatectomy with splenectomy [J]. World J Surg, 2007, 31(2): 375382.
14. Lee SE, Jang JY, Lee KU, et al. Clinical comparison of distal pancreatectomy with or without splenectomy [J]. J Korean Med Sci, 2008, 23(6): 10111014.
15. Kimura W, Yano M, Sugawara S, et al. Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 813823.
16. Miura F, Takada T, Asano T, et al. Gastric varices occurring after middlesegment pancreatectomy preserving spleen with division of splenic artery and vein [J]. Surgery, 2004, 135(6): 696697.
17. Miura F, Takada T, Asano T, et al. Hemodynamic changes of splenogastric circulation after spleenpreserving pancreatectomy with excision of splenic artery and vein [J]. Surgery, 2005, 138(3): 518522.
18. Tien YW, Liu KL, Hu RH, et al. Risk of varices bleeding after spleenpreserving distal pancreatectomy with excision of splenic artery and vein [J]. Ann Surg Oncol, 2010, 17(8): 21932198.
  1. 1. Warshaw AL. Conservation of the spleen with distal pancreatectomy [J]. Arch Surg, 1988, 123(5): 550553.
  2. 2. 代文杰, 姜洪池, 喬海泉. 保留脾臟的胰體尾切除術(shù) [J]. 中國實(shí)用外科雜志, 2001, 21(4): 245247.
  3. 3. 甄作均, 王峰杰. 胰體尾部腫瘤手術(shù)切除的相關(guān)問題 [J]. 實(shí)用醫(yī)學(xué)雜志, 2010, 26(10): 16811683.
  4. 4. 謝敏, 王健, 包善華, 等. 保脾胰體尾切除術(shù)在胰體尾病變時(shí)的應(yīng)用 [J]. 現(xiàn)代醫(yī)學(xué), 2009, 37(4): 308309.
  5. 5. 劉吉寶, 郭予, 魏毓龍. 20例胰體尾癌的外科治療體會(huì) [J]. 醫(yī)學(xué)論壇雜志, 2006, 27(14): 4445.
  6. 6. 翟剛, 李強(qiáng). 保留脾臟的胰體尾癌切除術(shù)18例 [J]. 腫瘤研究與臨床, 2009, 21(8): 482483.
  7. 7. 劉騫, 邵永孚, 王成峰, 等. 保留脾臟的胰體尾癌切除14例分析 [J]. 中華肝膽外科雜志, 2005, 11(4): 248249.
  8. 8. Shoup M, Conlon KC, Klimstra D, et al. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? [J]. J Gastrointest Surg, 2003, 7(8): 946952.
  9. 9. 邱應(yīng)和, 劉也夫, 姜小清, 等. 胰體尾癌的外科治療 [J]. 中華胰腺病雜志, 2008, 8(4): 272273.
  10. 10. Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients [J]. Ann Surg, 1999, 229(5): 693700.
  11. 11. Benoist S, Dugué L, Sauvanet A, et al. Is there a role of preservation of the spleen in distal pancreatectomy? [J]. J Am Coll Surg, 1999, 188(3): 255260.
  12. 12. Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy [J]. Arch Surg, 2002, 137(2): 164168.
  13. 13. Carrère N, Abid S, Julio CH, et al. Spleenpreserving distal pancreatectomy with excision of splenic artery and vein: a casematched comparison with conventional distal pancreatectomy with splenectomy [J]. World J Surg, 2007, 31(2): 375382.
  14. 14. Lee SE, Jang JY, Lee KU, et al. Clinical comparison of distal pancreatectomy with or without splenectomy [J]. J Korean Med Sci, 2008, 23(6): 10111014.
  15. 15. Kimura W, Yano M, Sugawara S, et al. Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 813823.
  16. 16. Miura F, Takada T, Asano T, et al. Gastric varices occurring after middlesegment pancreatectomy preserving spleen with division of splenic artery and vein [J]. Surgery, 2004, 135(6): 696697.
  17. 17. Miura F, Takada T, Asano T, et al. Hemodynamic changes of splenogastric circulation after spleenpreserving pancreatectomy with excision of splenic artery and vein [J]. Surgery, 2005, 138(3): 518522.
  18. 18. Tien YW, Liu KL, Hu RH, et al. Risk of varices bleeding after spleenpreserving distal pancreatectomy with excision of splenic artery and vein [J]. Ann Surg Oncol, 2010, 17(8): 21932198.

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