Splenic vessel blocking technique in the use of laparoscopic spleen-preserving distal pancreatectomy
10.3760/cma.j.cn115396-20240714-00217
- VernacularTitle:脾脏血流阻断在腹腔镜保留脾脏胰体尾切除术中的临床应用
- Author:
Shasha PENG
1
;
Qi LU
Author Information
1. 黄石市中心医院 湖北理工学院附属医院肝胆胰腺外科，黄石 435000
- Keywords:
Laparoscopes;
Pancreas;
Splenic artery;
Kimura technique;
Distal pancreatectomy;
Spleen-preserving
- From:
International Journal of Surgery
2024;51(12):803-808
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of splenic blood flow blockade in Kimura laparoscopic splenic body and pancreatic caudectomy.Methods:A retrospective case-control study was used to analyze the clinical data of 48 patients undergoing Kimura laparoscopic splenopancreato-caudectomy in Huangshi Central Hospital from January 2018 to December 2023. According to whether the splenic arteriovenous occlusion was performed during the operation, 25 cases were divided into a blocking group and 23 cases were not blocked. The operative time, intraoperative blood loss, intraoperative blood transfusion cases, postoperative drainage tube placement time, postoperative hospitalization days and postoperative complication rate were compared between the two groups. Measurement data with normal distribution were represented by mean±standard deviation ( ± s), independent sample t-test was used for inter-group comparison, and chi-square test was used for inter-group comparison. Results:The operation was successfully performed in both groups without perioperative death. In the blocking group, the operation time, intraoperative blood loss and postoperative hospitalization time were (166.4±28.3) min, (390.5±88.9) mL and (6.5±1.6) d, respectively. The results were significantly better than those in the unblocked group (191.5±29.7) min, (552.2±108.3) mL and (8.3±2.8) d( P<0.05). There were no intraoperative transfusion cases in the blocking group and 4 cases in the non-blocking group, and the difference between the two groups was statistically significant ( P<0.05). There were 2 cases of partial infarct in the blocking group and 1 case in the unblocking group, and there was no significant difference between the two groups ( P>0.05). There were 4 cases in the non-blocking group, and no cases in the blocking group. The splenectomy rate in the blocking group was significantly lower than that in the non-blocking group ( P<0.05). There was no significant difference in the incidence of other postoperative complications (thrombocytosis, portal vein thrombosis, B/C grade pancreatic leakage and perigastric varicose veins) in the blocking group compared with the non-blocking group ( P>0.05). Conclusions:Splenic blood flow blockade Kimura method is safe and effective. Intraoperative splenic arteriovenous blockade has more advantages in controlling intraoperative bleeding and successfully preserving spleen, which can accelerate the recovery of patients and is more in line with the concept of ERAS.
