In surgical operations, many people have doubts about removing the spleen when removing the pancreas. Especially for patients who have undergone "tail pancreatectomy", it is even more uncomfortable to remove two organs at one time. Puzzled. Doctors pointed out that the tail of the pancreas is often wrapped in the splenic hilum, and the splenic artery and vein are buried in the pancreas. This "you wrap me, I wrap you" structure often results in the pancreas and spleen often not being preserved. The application of laparoscopic surgery provides new opportunities for pancreatic tail surgery. Doctors said that the application of laparoscopic surgery provides new opportunities for pancreatic tail surgery.

Dr. Zhao Ruiying from the General Surgery Department of Tainan National Cheng Kung University Hospital pointed out that the pancreas and spleen are closely related to the human immune system. According to foreign statistics, patients who have had splenectomy are more likely to get serious infections, and the number of colds will decrease. There are more spleens than normal people, so how to preserve the spleen during pancreatic tail surgery has always been one of the difficult problems in surgery.

Due to the advancement of laparoscopic instruments and technology in the past 20 years, many traditional laparotomy surgeries have been gradually replaced by laparoscopy. However, pancreatic surgery is an abdominal surgery that is difficult and has high complications. , so the application of laparoscopy came later than other organs, and is limited to surgeons who specialize in pancreatic surgery.

Chengda Hospital has always been the leader in pancreatic surgery in Taiwan. Since 2008, it has introduced advanced laparoscopic instruments and technology for the resection of pancreatic tail tumors, providing better and more accurate treatment. The clear imaging system and more efficient hemostatic equipment can clearly see the direction of the spleen blood vessels, and can perform hemostasis on small blood vessels in a small space. In addition, there is a set of standard surgical procedures, which can make the surgery more efficient and systematic. Dr. Zhao Ruiying (right) pointed out that laparoscopic surgery allows the tail of the pancreas to be removed without sacrificing the spleen. (Photo courtesy of National Cheng Kung University Hospital)

So far, a total of 30 patients have undergone laparoscopic pancreatic tail resection, and all patients have successfully completed the surgery laparoscopically. The benefits of laparoscopic surgery include smaller wounds, less pain, less blood loss, and shorter hospital stays.

What is encouraging is that laparoscopic surgery successfully preserved the spleens of 18 patients, with an overall spleen preservation rate of 60%. Compared with the previous traditional laparotomy, the spleen preservation rate was only 10%. About %, laparoscopy is used in distal pancreatic surgery, which greatly improves the spleen preservation rate.

Hospital statistics also found that for patients with tumors less than 5 cm, the spleen preservation rate is 100%; when the tumor is larger than 5 cm, the spleen preservation rate drops to 37.5, and there are higher complications. . Therefore, studies have found that patients with benign or low-malignant tumors in the tail of the pancreas, especially those with tumors smaller than 5 cm, are recommended to undergo laparoscopic surgery. In addition to one of the advantages of laparoscopic surgery itself, more importantly It is "resection of the tail of the pancreas, and the spleen is no longer sacrificed."