Laparoscopic distal pancreatectomy: the experience of 68 cases in a single centre / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and efficacy of laparoscopic distal pancreatectomy.</p><p><b>METHODS</b>Totally 68 patients (male 23, female 45) aged 17 to 77 years, with distal pancreatic lesions, underwent laparoscopic distal pancreatectomy from November 2003 to December 2010. The clinical data were collected. Safety, feasibility and crucial technique manipulation were analyzed retrospectively.</p><p><b>RESULTS</b>All 68 operations were successful with two cases conversion to open, including 48 cases combined with splenectomy, and 18 cases with preservation of spleen. Fourteen cases received with combination resection of multi-organs, including 4 cases with cholecystectomy, 1 case resection of right adrenal adenoma and cholecystectomy, 1 case with myomectomy and left ovarian teratomectomy; 1 case with right ovarian teratomectomy, 1 case with resection of left adrenal adenoma, 1 case with resection of both adrenal adenoma, 1 case with resection of liver metastasis, 1 case with cholecystectomy and resection of liver metastasis, 1 case with resection of left adrenal adenoma and liver metastasis, 1 case with resection of left adrenal adenoma and colon and spleen, 1 case with biopsy of liver nodule. The mean operative time was (209 ± 58) minutes, the mean intraoperative blood loss was (191 ± 123) ml, and the mean postoperative hospital stay was (8 ± 4) days. The rate of overall postoperative complications was 18.1%, including an 12.1% rate of clinical pancreatic fistula. Only one case needed a reoperation, and there was no postoperative mortality.</p><p><b>CONCLUSION</b>Laparoscopic distal pancreatectomy with or without splenectomy is safe and feasible in the treatment of most distal pancreatic tumors.</p>

Study on the quality of life after pancreaticoduodenectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the quality of life (QOL) of the patients who received pancreaticoduodenectomy (PD) and work out their long term therapy agents.</p><p><b>METHODS</b>QOL of 18 cases who received PD (group PD) and 18 cases received laparoscopic cholecystectomy (LC) (group LC) in the same days was determined by symptoms questionnaire and Chinese version SF-36 QOL questionnaire from Jan 2002 to Dec 2003 in Sir Run Run Shaw Hospital.</p><p><b>RESULTS</b>Compared with group LC, the total QOL score and physical health score of group PD didn't have significant decrease. But the mental health score of group PD was lower than group LC (P < 0.05). Eight different scales of SF-36 questionnaire showed that the score in physical functioning, role-physical, bodily pain, general health, social functioning of group PD was lower than that of group LC. The score in vitality, role-emotional and mental health of group PD was the same as the group LC. According to the symptoms questionnaire, the patient diarrhea and recurrence had obvious influence on PH score. The patient weight loss and unemployment had obvious influence on MH2 score.</p><p><b>CONCLUSIONS</b>The QQL of patients received PD didn't have decreased. Their total score of SF-36 QQL was close to the patients who received LC. But the mental health score of group PD was lower than group LC. Weight loss, unemployment, recurrence and chronic pancreatic diarrhea may be infect the Quality of life after PD.</p>