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

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

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

原文：
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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