KẾT QUẢ SỚM PHẪU THUẬT CẮT LÁCH THÂN ĐUÔI TỤY TẠI BỆNH VIỆN K

Abstract

Objective: To evaluate the early outcomes of distal pancreatectomy with splenectomy (DPSS) for the treatment of pancreatic body and tail lesions. Subject and method: A retrospective observational study was conducted on patients who underwent DPSS at the Department of Hepatobiliary and Pancreatic Surgery, K Hospital from November 2020 to February 2024. Results: A total of 26 patients were included in the study. The mean age was 53.7 ± 16.9 years, and the female-to-male ratio was 2.25:1. Epigastric pain was the most common symptom, reported in 20 patients (76.9%). CA 19-9 was elevated in 6 patients (23.1%). The mean tumor size on computed tomography (CT) was 5.1 ± 2.5 cm. Preoperative biopsy was performed in 5 patients (19.2%). The majority of patients had soft pancreatic parenchyma (53.8%). Pancreatic transection was mainly performed using a stapler in 16 cases (61.5%), and reinforcement of the pancreatic cut surface was performed in 21 patients (80.8%). Resection of adjacent organs was performed in 3 patients (10.7%). The mean operative time was 133.8 ± 43.4 minutes. The majority of postoperative pathological results were malignant, with 12 cases (46.2%). Two patients had lymph node metastasis (7.7%). A total of 19 complications (73.1%) occurred, including pancreatic fistula (57.7%), all of which were grade A; post-operative pancreatitis (7.7%), abdominal effusion (3.8%), and post-operative bleeding (3.8%). Fifteen patients (57.7%) experienced post-operative complications, mainly grade I (53.3%) according to the Clavien-Dindo classification. The mean length of hospital stay was 9.4 ± 2.8 days. Conclusion: DPSS is a surgery that should be performed in specialized centers. The most common complication is pancreatic fistula.