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    题名 作者 年代 出处 被引量
1微创外科时代脾脏外科的现状与展望显示文摘脾脏仍是一个神秘的脏器,除了本身特有的疾病以外,许多其他脏器的功能障碍也会累及脾脏,因而脾脏疾病的诊治既错综复杂又风险高、难度大。杨镇 2015腹部外科2015,0,6:2
2“Parenchyma transection-first”strategy is superior to“tunnel-first”strategy in robotic spleen-preserving distal pancreatectomy with conservation of splenic vessels显示文摘Background: Creating a tunnel between the pancreas and splenic vessels followed by pancreatic parenchyma transection(“tunnel-first” strategy) has long been used in spleen-preserving distal pancreatectomy(SPDP) with splenic vessel preservation(Kimura’s procedure). However, the operation space is limited in the tunnel, leading to the risks of bleeding and difficulties in suturing. We adopted the pancreatic “parenchyma transection-first” strategy to optimize Kimura’s procedure. Methods: The clinical data of consecutive patients who underwent robotic SPDP with Kimura’s procedure between January 2017 and September 2022 at our center were retrieved. The cohort was classified into a “parenchyma transection-first” strategy(P-F) group and a “tunnel-first” strategy(T-F) group and analyzed. Results: A total of 91 patients were enrolled in this cohort, with 49 in the T-F group and 42 in the P-F group. Compared with the T-F group, the P-F group had significantly shorter operative time(146.1 ± 39.2 min vs. 174.9 ± 46.6 min, P < 0.01) and lower estimated blood loss [40.0(20.0–55.0) m L vs. 50.0(20.0–100.0) m L, P = 0.03]. Failure of splenic vessel preservation occurred in 10.2% patients in the TF group and 2.4% in the P-F group( P = 0.14). The grade 3/4 complications were similar between the two groups( P = 0.57). No differences in postoperative pancreatic fistula, abdominal infection or hemorrhage were observed between the two groups. Conclusions: The pancreatic “parenchyma transection-first” strategy is safe and feasible compared with traditional “tunnel-first strategy” in SPDP with Kimura’s procedure.Meng-Yang Li Hao-Zhe Cui Jia-Ning Hao Da-Bin Xu En-Li Zhang Zhu-Zeng Yin Zhi-Ming Zhao 2023Hepatobiliary & Pancreatic Diseases International2023,22,6:0
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