Abstract:Objective: To investigate the effect of laparoscopic resection of pancreatic body and tail on splenic immune function and blood supply in spleen. Methods: The clinical data of 80 cases underwent splenectomy and pancreatic body resection were retrospectively analyzed. The changes of immune function and the blood supply of spleen after open pancreatectomy and laparoscopic resection of pancreatic body and tail were compared. Results: The levels of IgG and CD4+ and CD8+T cells in the two groups were lower than those before operation (P<0.05). The level of IgG in the observation group after 1 days was higher than that in the control group, and the scores of CD4+ and CD8+T cells were lower than those of the control group (P<0.05). Two groups of patients had postoperative arteriovenous patency decreased (P<0.05); In the postoperative, the observation group patients arteriovenous patency was significantly higher than the control group (P<0.05). After 1 month, the spleen perfusion in the observation group was significantly better than that in the control group (P<0.05). Conclusion: The short-term prognosis of laparoscopic pancreatic body and tail resection is better than that of laparotomy group, and has less influence on the immune function.
丁兵, 蒋辉. 腹腔镜行胰体尾切除术患者术后对脾脏中免疫功能及脾脏血液供应的影响[J]. 河北医学, 2017, 23(10): 1615-1618.
DING Bing, JIANG Hui. Effect of Laparoscopic Resection of Pancreatic Body and Tail on |Splenic Immune Function and Blood Supply in Spleen. 河北医学, 2017, 23(10): 1615-1618.
[1]李留峥,彭联芳,向春明,等.胰头肿块型慢性胰腺炎手术治疗体会[J].肝胆胰外科杂志,2015,27(1):47~49. [2] Kang C M. Is Robot-assisted Minimally Invasive Distal Pancreatectomy Superior to the Laparoscopic Technique[J].Annals of Surgery, 2015, 261(6):e153. [3] 常清, 饶丹,赵晓辉,等.不同脾保留术对外伤性Ⅱ级脾破裂的疗效及其对免疫功能的影响[J].中国临床研究,2016,29(1):78~80. [4] 汤善宏,何煊,王钊,等.部分脾动脉栓塞治疗慢性胰腺炎相关脾静脉血栓致区域性门静脉高压1例报告[J].临床肝胆病杂志,2015,31(5):771~772. [5] 马振刚.腹腔镜胆囊切除术治疗急性发作期胆囊炎的临床分析[J].中国医药导刊,2015,17,(1):34~35. [6] 刘荣,许大彬.腹腔镜下胰腺体尾部切除术(保留脾血管)[J].中华普外科手术学杂志电子版,2015,9,(4):22. [7] 磨庆福.重症急性胰腺炎的发病原因及发病机制研究进展[J].胃肠病学和肝病学杂志,2014,23(9):1107~1110. [8] Kooby D A, Vollmer C M. Laparoscopic versus open distal pancreatectomy: is a randomized trial necessary[J].Journal of hepato-biliary-pancreatic Sciences, 2015, 22(10):737. [9] Yu X, Li H, Jin C, et al. Splenic vessel preservation versus Warshaw’s technique during spleen-preserving distal pancreatectomy: a meta-analysis and systematic review[J].Langenbecks Archives of Surgery, 2015, 400(2):183~191. [10] Yoon Y S, Lee K H, Han H S, et al. Effects of laparoscopic versus open surgery on splenic vessel patency after spleen and splenic vessel-preserving distal pancreatectomy: a retrospective multicenter study[J].Surgical Endoscopy, 2015, 29(3):583~588.