腹腔镜次全胰脏切除并脾脏保留之影片分享.PPT

Discussion LSPDP(保留脾臟) versus LDPS(切除脾臟) Increased risk of severe infection Thrombocytosis, cause blood clots LSPDP(保留脾臟) versus LDPS(切除脾臟) Higher overall morbidity Higher abdominal abscess rates Higher in-hospital costs M.-H. Dai et al (2016) Splenic preservation in laparoscopic distal pancreatectomy. British Journal of Surgery Tomohide H et al (2015) Laparoscopic Distal Pancreatectomy with or without Preservation of the Spleen for Solid Pseudopapillary Neoplasm. Lap-W versus Lap-SVP Intraoperative splenic infarction Preserving short gastric vessels, splen-colic ligament, left gastroepiploic vessels Yoshiharu N et al (2016), Study on laparoscopic spleen preserving distal pancreatectomy procedures comparing splenic vessel preservation and nonpreservation. Transl Gastroenterol Hepatol Lap-W versus Lap-SVP Detachment work is difficult 3cm Yoshiharu N et al (2016), Study on laparoscopic spleen preserving distal pancreatectomy procedures comparing splenic vessel preservation and nonpreservation. Transl Gastroenterol Hepatol M.-H. Dai et al (2016) Splenic preservation in laparoscopic distal pancreatectomy. British Journal of Surgery Stefano P et al (2015) A systematic review and meta-analysis of spleen-preserving distal pancreatectomy with preservation or ligation of the splenic artery and vein 吳柏宣 陳臨安 黃建偉 蘇文隆 張文燦 王森稔 莊世昌 郭功楷 陳榮祥 李金德 高雄醫學大學附設中和紀念醫院一般消化系外科 Basic data Name: 許O惠 Age: 23 y/o Gender: female Past history: nil Chief complaint: Accidental finding of tumor over pancreas tail Clinical course 1/7 Traffic accident, 埔里 H. 1/8 KMUH Abdominal CT Suspect solid pseudopapillary tumour of the pancreas 3/15 Operation Solid-pseudopapillary neoplasm Rare, 3% Low-grade malignant neoplasm Metastasis occurs in 5–15% of cases Tomohide H et al (2015) Laparoscopic Distal Pancr