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Case-matched study of lesser versus greater curvature approach in laparoscopic Warshaw pancreatectomy 病例对照研究较小的和更大的曲率的方法腹腔镜Warshaw法胰腺切除术 Abstract 摘要 Background 背景 In laparoscopic distal pancreatectomy (LapDP), the pancreas is accessed in a greater curvature approach (GCA). The lesser curvature approach (LCA) has been proposed in underweight patients. The study investigated the feasibility of LCA irrespective of the body mass index (BMI). 腹腔镜胰体尾切除术(LapDp),胰腺被访问在一个更大的曲率的方法(GCA)。小曲率法(LCA)一直在低体重患者的建议。本研究探讨LCA的可行性不论身体质量指数(BMI)。 Methods 方法 This retrospective study included consecutive patients scheduled to undergo LapDP with the LCA. A matched cohort (1:1) underwent GCA. Spleen preservation was performed using the Warshaw technique. Splenic perfusion was intraoperatively assessed by indocyanine green (ICG) angiography. 该回顾性研究纳入患者计划包括lapdp与LCA患者。一个匹配队列(1:1)接受 GCA。保脾术使用Warshaw技术进行。脾灌注术由吲哚青绿(ICG)造影评估。 Results 结果 The LCA with LapDP was successful in 12/15 patients. In 2 cases, LCA had to be converted to GCA and in 1 patient to open surgery. The cohorts were well matched in sex (P = 1.0), age (P = .67), indication (P = 1.0), and median BMI (23.4 kg/m2 vs 24.8 kg/m2, P = .41). Splenic preservation was achieved in 14/15 patients with LCA and 4/15 patients with GCA (P = .33). In all LCA cases, ICG angiography indicated sufficient spleen perfusion. The groups had similar morbidity (P = 1.0) and hospital stay (P = .74). LapDP和LCA成功在12 /15患者实行。2例,LCA必须转换为GCA和1例开放手术。队列匹配良好(P = 1.0),年龄(P = .67),指示(P =1.0),平均体重指数(23.4 kg/m2 vs 24.8 kg/m2, P = .41)。保脾术14/15患者和4/15的LCA患者(P = .33)。在所有的LCA案例,ICG 血管造影显示足够的脾灌注。该组中有相似的发病率(P = 1.0)和住院时间(P = .74)。 Conclusions 结论 LCA was feasible in 80% irrespective of BMI and provided an excellent field of exposure. ICG angiography was feasible in the Warshaw technique. Its reliability should be evaluated in prospective studies. LCA80%是可行的,不考虑体重指数,并提供了一个极好的领域。ICG血管造影在Warshaw技术是可行的。在前瞻性研究中,应评估其可靠性。 Keywords 关键词 Laparoscopic distal pancreatectomy; Laparoscopic pancreatic techniques; Splenic preservation; Lesser curvature approach; ICG; Splenic perfusion 腹腔镜胰体尾切除术,腹腔镜胰腺技术,保脾,较小的曲率法,ICG,脾灌注 原文: |