Left-posterior approach for artery-first en bloc resection in laparoscopic distal pancreatectomy for left-sided pancreatic cancer
Left-posterior approach for artery-first en bloc resection in laparoscopic distal pancreatectomy for left-sided pancreatic cancer
复制标题
左后入路先行动脉整块切除腹腔镜左侧胰腺癌远端胰腺切除术
DOI：
10.1007/s00423-020-02021-8
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Masui Toshihiko
中科院分区：
文献类型：
--
作者：
Nagai Kazuyuki;Kiguchi Gozo;Yogo Akitada;Anazawa Takayuki;Yagi Shintaro;Taura Kojiro;Takaori Kyoichi;Masui Toshihiko
PurposeWe描述了一个“左后方的方法”，在腹腔镜远端胰腺切除术（LDP）的左侧胰腺癌的重要步骤是在尾侧和背侧的方向完成的pancreat.MethodsThe患者谁接受了LDP与左后方的方法在我院从2016年1月至2020年4月进行了审查，以评估短期的术后结果。在LDP中，我们首先解剖左肾静脉和上级肠系膜动脉上方的腹膜后组织，广泛游离胰体。然后，在腹侧提升的胰腺后方分离脾动脉作为动脉优先入路。在同一术野内连续进行区域性淋巴结清扫。胰腺的颈部被横断与线性吻合器动员后的spleen.ResultsIn 9例患者（5男4女）年龄76岁（范围：64-82岁），手术时间为398分钟（276-482分钟），估计失血量为40毫升（0-80毫升）。无患者发生B/C级胰瘘或胃排空延迟。1例患者（腹腔脓肿）发生了Clavien-Dindo分类中归类为III级的术后并发症。病理学证实，所有患有胰腺癌（n= 5）、IPMN（n= 3）和高级别胰腺上皮内瘤变（PanIN）（n= 1）的患者均行R 0切除术。结论左后入路是治疗左侧胰腺癌的合理手术方法。
PurposeWe describe a “left-posterior approach” in which the important steps in laparoscopic distal pancreatectomy (LDP) for left-sided pancreatic cancer are accomplished in the direction caudal and dorsal to the pancreas.MethodsThe patients who underwent LDP with a left-posterior approach at our hospital from January 2016 to April 2020 were reviewed to evaluate the short-term postoperative outcomes. In LDP, we first dissected retroperitoneal tissues above the left renal vein and superior mesenteric artery, yielding the mobilization of the pancreatic body widely. Then, the splenic artery was divided behind the ventrally lifted pancreas as an artery-first approach. The regional lymphadenectomy was performed in an en bloc manner consecutively in the same operative field. The neck of the pancreas was transected with a linear stapler after mobilization of the spleen.ResultsIn nine patients (five men and four women) aged 76 years (range: 64–82 years), the operative time was 398 min (276–482 min) with the estimated blood loss of 40 ml (0–80 ml). No patients developed grade B/C pancreatic fistula or delayed gastric emptying. Postoperative complications classified as grade III in the Clavien–Dindo classification occurred in one patient (abdominal abscess). The pathology confirmed R0 resection in all patients who had pancreatic cancer (n= 5), IPMNs (n= 3), and high-grade pancreatic intraepithelial neoplasia (PanIN) (n= 1). The number of retrieved lymph nodes was 35 (11–49).ConclusionThe procedure with a left-posterior approach is a rational surgical technique in LDP for left-sided pancreatic cancer.
登录
查看更多内容
影响因子：
2.3
作者：
Kim, Seongho;Yoon, Yoo-Seok;Cho, Jai Young
通讯作者：
Cho, Jai Young
DOI：
10.1007/s00464-019-07047-8
发表时间：
2020-06-01
影响因子：
3.1
作者：
Hong, Sarang;Song, Ki Byung;Kim, Song Cheol
通讯作者：
Kim, Song Cheol
动脉优先远端胰腺切除术
影响因子：
2.7
作者：
K. Takaori;S. Uemoto
通讯作者：
S. Uemoto
影响因子：
1.9
作者：
Kim EY;Hong TH
通讯作者：
Hong TH
影响因子：
3
作者：
Grossman, Julie G.;Fields, Ryan C.;Strasberg, Steven M.
通讯作者：
Strasberg, Steven M.