Clinical efficacy for precise pancreatectomy for benign lesion

Objective: To investigate the feasibility,safety,effect of spleen-preserving precise pancreatectomy,and to discuss its indications and techniques.Methods: The clinical data of seventeen patients undergoing precise pancreatectomy with spleen preserved between Jan 2007 and December 2010 were analyzed retrospectively.Results: Out of the seventeen cases,eleven cases received distal pancreatectomy,while other five cases received the middle pancreatectomy,only one case received duodenum-preserving pancreatectomy.Frozen section examination of the pancreatic stumps,however,revealed malignant changes in two cases of the distal pancreatectomy patients,and splenectomy was then performed.The operation time was(3.0±0.78) h and the intraoperative blood loss was(258.8±86.65) ml.Only one case suffered from pancreatic fistula,who finally recovered after medicine therapy and percutaneous drainage;one case suffered from delayed bleeding of splenic vein,who then recovered after splenectomy;one case of small pancreatic cyst finally recovered after medicine therapy.There was no other complication or operative mortality.The postoperative platelet count was(273.1±43.76)×109·L-1 and the postoperative hospital stay was(15.8±7.07) d.For seventeen cases of patients,no recurrence and metastasis was found after the follow up(16.2±8.14) months(4-48 months).Conclusion: Precise pancreatectomy with spleen preserved is a safe and feasible procedure,which is worthy for selected cases such as benign neoplasm of the body,tail and even the head of the pancreas,resulting minimal invasion,maximal tissue reserve and optimal rehabilitation.