The evaluation of spleen-preserving distal pancreatectomy for children with distal pancreatic injures_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Wei ¹ , ZHANG Chong ² , LI Guixian ¹ ,  YAO Hongbing ¹ , WU Jiaxing ¹ , JIANG Jianhui ¹

1. Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi Zhuang Autonomous Region 541199, P. R. China;
2. Department of Neurology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi Zhuang Autonomous Region 541199, P. R. China;

Corresponding?author：

YAO Hongbing, Email: 156808015@qq.com

Keywords：

pancreatic injury; children; spleen-preserving distal pancreatectomy

DOI：

10.7507/1007-9424.201810038

Video：

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Objective To explore the safety and feasibility of spleen-preserving distal pancreatectomy for children with distal pancreatic injures.Methods Clinical data of 10 patients with severe distal pancreatic injures in The Second Affiliated Hospital of Guilin Medical University from January 2012 to July 2017 were retrospectively analyzed. The intraoperative and postoperative situation including operation time, intraoperative blood loss, postoperative blood platelet count, and perioperative complications were observed.Results All the 10 patients underwent spleen-preserving distal pancreatectomy successfully. The median operation time was 3 h (2–6 h), the median intraoperative blood loss was100 mL (50–300 mL), the postoperative blood platelet count ranged from 75×10⁹/L to 260×10⁹/L with the median postoperative blood platelet count was 175×10⁹/L. Two patients suffered from pancreatic leakage, one patient suffered from subphrenic infection, and one patient suffered from pulmonary infection. All patients suffered from complication recovered after symptomatic treatments. All patients were followed up in the outpatient department, the follow-up time was 4–60 months with a median of 30 months. Reexamination of abdominal ultrasound and blood routine (every 3 months after surgery) showed that, no abnormalities in blood supply, morphology, and structure of spleen, and platelet counts fluctuated within the normal range. During the follow-up period, none of the children suffered from severe infection due to hyposplenic function.Conclusion Spleen-preserving distal pancreatectomy is a safe and effective method for children with distal pancreatic injures.

Citation： GUO Wei, ZHANG Chong, LI Guixian, YAO Hongbing, WU Jiaxing, JIANG Jianhui. The evaluation of spleen-preserving distal pancreatectomy for children with distal pancreatic injures. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(2): 153-156. doi: 10.7507/1007-9424.201810038 Copy

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2.	蕭崗, 任培土, 魯葆春. 胰腺損傷 58 例診治體會. 肝膽胰外科雜志, 2014, 26(2): 154-156.
3.	Moore EE, Cogbill TH, Malangoni MA, et al. Organ injury scaling, Ⅱ: pancreas, duodenum, small bowel, colon, and rectum. J Trauma, 1990, 30(11): 1427-1429.
4.	張雋開, 譚廣, 羅海峰, 等. 雙套管引流灌洗治療胰腺手術后胰瘺: 附 33 例報告. 中國普通外科雜志, 2014, 23(3): 389-391.
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6.	Vasquez M, Cardarelli C, Glaser J, et al. The ABC’s of pancreatic trauma: airway, breathing, and computerized tomography scan? Mil Med, 2017, 182(S1): 66-71.
7.	劉續寶, 熊俊杰, 胰腺, 等. 胰腺及十二指腸損傷早期診斷. 中國實用外科雜志, 2015, 35(3): 248-252.
8.	Christodoulou DK, Tsianos EV. Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases. World J Gastroenterol, 2010, 16(38): 4755-4761.
9.	Mahajan A, Kadavigere R, Sripathi S, et al. Utility of serum pancreatic enzyme levels in diagnosing blunt trauma to the pancreas: a prospective study with systematic review. Injury, 2014, 45(9): 1384-1393.
10.	Westgarth-Taylor C, Loveland J. Paediatric pancreatic trauma: a review of the literature and results of a multicentre survey on patient management. S Afr Med J, 2014, 104(11 Pt 2): 803-807.
11.	Englum BR, Gulack BC, Rice HE, et al. Management of blunt pancreatic trauma in children: review of the National Trauma Data Bank. J Pediatr Surg, 2016, 51(9): 1526-1531.
12.	Maeda K, Ono S, Baba K, et al. Management of blunt pancreatic trauma in children. Pediatr Surg Int, 2013, 29(10): 1019-1022.
13.	Lahiri R, Bhattacharya S. Pancreatic trauma. Ann R Coll Surg Engl, 2013, 95(4): 241-245.
14.	Kottapalli DC, Devashetty S, Suryanarayana VR, et al. Complete pancreatic duct disruption in an isolated pancreatic injury: successful endoscopic management. Oxf Med Case Reports, 2016, 2016(3): 44-46.
15.	Rosenfeld EH, Vogel AM, Klinkner DB, et al. The utility of ERCP in pediatric pancreatic trauma. J Pediatr Surg, 2018, 53(1): 146-151.
16.	丁威威, 王凱, 劉寶晨. 胰腺外傷單中心 136 例診治報告. 中國實用外科雜志, 2018, 38(7): 782-785.
17.	Peck GL, Blitzer DN, Bulauitan CS, et al. Outcomes after distal pancreatectomy for trauma in the Modern Era. Am Surg, 2016, 82(6): 526-532.
18.	Chanis W, Pataki I, Mohos G, et al. Organ saving intervention for pancreatic trauma. Magy Seb, 2016, 69(3): 113-116.
19.	戴睿武. 胰腺損傷救治中的幾個重要問題. 創傷外科雜志, 2017, 19(4): 241-243.
20.	Santos-Antunes J, Moutinho-Ribeiro P, Macedo G. Endoscopic management of late complication of blunt traumatic total pancreatic transection. Rev Esp Enferm Dig, 2016, 108(11): 735-736.
21.	Ciftci F, Abdulrahman I, Ibrahimoglu F, et al. Early-stage quantitative analysis of the effect of laparoscopic versus conventional inguinal hernia repair on physical activity. Chirurgia (Bucur), 2015, 110(5): 451-456.
22.	劉志偉, 蔡守旺, 何蕾. 創傷性胰腺損傷診斷治療的臨床分析. 中華肝膽外科雜志, 2012, 18(9): 676-679.
23.	李長春, 王珊, 李曉慶, 等. 腹部閉合傷致兒童胰腺外傷的診治探討. 中華小兒外科雜志, 2009, 30(4): 231-234.
24.	王義濤, 齊浩龍, 郭濤, 等. 胰體尾切除術后胰瘺的防治. 腹部外科, 2014, 27(5): 377-380.
25.	Malde DJ, Khan A, Prasad KR, et al. Inferior vena cava resection with hepatectomy: challenging but justified. HPB (Oxford), 2011, 13(11): 802-810.
26.	蔣國慶, 柏斗勝, 錢建軍, 等. 保留脾臟及供應血管胰體尾切除治療胰腺斷裂傷 18 例報道. 國際外科學雜志, 2014, 41(1): 29-31.
27.	曹金鐸. 脾臟外科. 北京: 人民衛生出版社, 2000: 19-68.
28.	陳國玉, 吳文溪. 外科學. 北京: 科學出版社, 2002: 570-572.
29.	Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy. Arch Surg, 2002, 137(2): 164-168.

1. Klin B, Abu-Kishk I, Jeroukhimov I, et al. Blunt pancreatic trauma in children. Surg Today, 2011, 41(7): 946-954.
2. 蕭崗, 任培土, 魯葆春. 胰腺損傷 58 例診治體會. 肝膽胰外科雜志, 2014, 26(2): 154-156.
3. Moore EE, Cogbill TH, Malangoni MA, et al. Organ injury scaling, Ⅱ: pancreas, duodenum, small bowel, colon, and rectum. J Trauma, 1990, 30(11): 1427-1429.
4. 張雋開, 譚廣, 羅海峰, 等. 雙套管引流灌洗治療胰腺手術后胰瘺: 附 33 例報告. 中國普通外科雜志, 2014, 23(3): 389-391.
5. 張俊晶, 孟興凱, 李得溪, 等. 閉合性胰腺損傷診療現狀. 中華急診醫學雜志, 2011, 20(2): 217-219.
6. Vasquez M, Cardarelli C, Glaser J, et al. The ABC’s of pancreatic trauma: airway, breathing, and computerized tomography scan? Mil Med, 2017, 182(S1): 66-71.
7. 劉續寶, 熊俊杰, 胰腺, 等. 胰腺及十二指腸損傷早期診斷. 中國實用外科雜志, 2015, 35(3): 248-252.
8. Christodoulou DK, Tsianos EV. Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases. World J Gastroenterol, 2010, 16(38): 4755-4761.
9. Mahajan A, Kadavigere R, Sripathi S, et al. Utility of serum pancreatic enzyme levels in diagnosing blunt trauma to the pancreas: a prospective study with systematic review. Injury, 2014, 45(9): 1384-1393.
10. Westgarth-Taylor C, Loveland J. Paediatric pancreatic trauma: a review of the literature and results of a multicentre survey on patient management. S Afr Med J, 2014, 104(11 Pt 2): 803-807.
11. Englum BR, Gulack BC, Rice HE, et al. Management of blunt pancreatic trauma in children: review of the National Trauma Data Bank. J Pediatr Surg, 2016, 51(9): 1526-1531.
12. Maeda K, Ono S, Baba K, et al. Management of blunt pancreatic trauma in children. Pediatr Surg Int, 2013, 29(10): 1019-1022.
13. Lahiri R, Bhattacharya S. Pancreatic trauma. Ann R Coll Surg Engl, 2013, 95(4): 241-245.
14. Kottapalli DC, Devashetty S, Suryanarayana VR, et al. Complete pancreatic duct disruption in an isolated pancreatic injury: successful endoscopic management. Oxf Med Case Reports, 2016, 2016(3): 44-46.
15. Rosenfeld EH, Vogel AM, Klinkner DB, et al. The utility of ERCP in pediatric pancreatic trauma. J Pediatr Surg, 2018, 53(1): 146-151.
16. 丁威威, 王凱, 劉寶晨. 胰腺外傷單中心 136 例診治報告. 中國實用外科雜志, 2018, 38(7): 782-785.
17. Peck GL, Blitzer DN, Bulauitan CS, et al. Outcomes after distal pancreatectomy for trauma in the Modern Era. Am Surg, 2016, 82(6): 526-532.
18. Chanis W, Pataki I, Mohos G, et al. Organ saving intervention for pancreatic trauma. Magy Seb, 2016, 69(3): 113-116.
19. 戴睿武. 胰腺損傷救治中的幾個重要問題. 創傷外科雜志, 2017, 19(4): 241-243.
20. Santos-Antunes J, Moutinho-Ribeiro P, Macedo G. Endoscopic management of late complication of blunt traumatic total pancreatic transection. Rev Esp Enferm Dig, 2016, 108(11): 735-736.
21. Ciftci F, Abdulrahman I, Ibrahimoglu F, et al. Early-stage quantitative analysis of the effect of laparoscopic versus conventional inguinal hernia repair on physical activity. Chirurgia (Bucur), 2015, 110(5): 451-456.
22. 劉志偉, 蔡守旺, 何蕾. 創傷性胰腺損傷診斷治療的臨床分析. 中華肝膽外科雜志, 2012, 18(9): 676-679.
23. 李長春, 王珊, 李曉慶, 等. 腹部閉合傷致兒童胰腺外傷的診治探討. 中華小兒外科雜志, 2009, 30(4): 231-234.
24. 王義濤, 齊浩龍, 郭濤, 等. 胰體尾切除術后胰瘺的防治. 腹部外科, 2014, 27(5): 377-380.
25. Malde DJ, Khan A, Prasad KR, et al. Inferior vena cava resection with hepatectomy: challenging but justified. HPB (Oxford), 2011, 13(11): 802-810.
26. 蔣國慶, 柏斗勝, 錢建軍, 等. 保留脾臟及供應血管胰體尾切除治療胰腺斷裂傷 18 例報道. 國際外科學雜志, 2014, 41(1): 29-31.
27. 曹金鐸. 脾臟外科. 北京: 人民衛生出版社, 2000: 19-68.
28. 陳國玉, 吳文溪. 外科學. 北京: 科學出版社, 2002: 570-572.
29. Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy. Arch Surg, 2002, 137(2): 164-168.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The evaluation of spleen-preserving distal pancreatectomy for children with distal pancreatic injures

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