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| An Analysis of the Effects of Laparoscopic Kimura Method and Warshaw Method on Perioperative Indexes and Postoperative Complications in Patients with Benign Pancreatic Body and Tail Lesions |
| LIU Fengling, ZHU Zhuoli, ZHANG Daizhong, et al |
| Dazhou Central Hospital, Sichuan Dazhou 635000, China |
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Abstract Objective: To observe the treatment effects and safety of laparoscopic Kimura method and Warshaw method on benign pancreatic body and tail lesions. Methods: Retrospective analysis was performed on clinical data of 83 patients who underwent laparoscopic spleen-preserving distal pancreatectomy in our hospital from January 2015 to October 2018. The patients were divided into Kimura group (49 cases) and Warshaw group (34 cases) according to different surgical methods. The perioperative indexes, and platelet changes and immune function changes before and after surgery were recorded in the two groups. The occurrence of complications were recorded in the two groups, and the long-term prognosis was evaluated with follow-up. Results: The operative time in Kimura group was significantly longer than that in Warshaw group (P<0.05), but there were no significant differences in the intraoperative blood loss, postoperative exhaust time, fasting time, hospital stay and somatostatin application time between the two groups (P>0.05). There was no significant difference in platelet level in the two groups at 1 week, 1 month and 3 months after surgery compared with that before surgery (P>0.05), and there was no difference between groups at the same time point (P>0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in Kimura group at 1 week and 1 month after surgery were not significantly different from those before surgery (P>0.05), and the levels of CD3+and CD4+ at 1 week after surgery in Warshaw group were significantly lower than those before surgery (P<0.05), and there were no significant differences at 1 month after surgery compared with those before surgery (P>0.05), but there were no statistically significant differences in the levels of CD3+, CD4+ and CD4+/CD8+ between the two groups at the same time point (P>0.05). The incidence rate of postoperative splenic infarction and the total incidence rate of complications were 0.00% and 10.20% in Kimura group, which were lower than those in Warshaw group with 11.76% and 29.41% (P<0.05). All patients were followed up for 12 to 37 months. No recurrence or reoperation was found. Conclusion: Both laparoscopic Kimura method and Warshaw method are effective methods for spleen-preserving distal pancreatectomy, and have similar effects on platelet and immune function of patients. Although Kimura method takes longer, it can reduce the incidence rate of complications. Warshaw method is more suitable for those with a large tumor range and difficulty in separating from the spleen blood vessels.
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2020, Vol. 26 
