Retrospective Analysis Of Resection Of Advanced Gastric Carcinoma Combined With Distal Pancreatectomy

Objective:To further investigate advanced gastric cancer combined distal pancreatectomy with pancreatic stump treatment, according to the postoperative complications severity and incidence to select appropriate approach.Methods: Rretrospective analysis was used to analyze57patients with gastric cancer pancreatic body and tail were resected successfully in the First Affiliated Hospital of Xinjiang Medical University from June2004to December2011. According to with or without splenectomy, patients were divided into the splenectomy group(n=36)and spleen-preserving group (n=21); and according to intraoperative pancreas stump handling divided into handmade group(n=30)and closer group(n=27). The incidence of postoperative complications, blood loss, surgical time were analyzed by statistical software SPSS19.0.Results:Pancreatic fistula was occurred in8patients (38.1%) of the spleen-preserving group, and it is10in the splenectomy group (27.8%); average operative time was300.35±11.15min in spleen-preserving group, and it is245.13+11.25min in the splenectomy group, the difference was statistically significant in two groups (P <0.05); pancreatic fistula occurred in6patients in handmade group(20%), and12patients in closer group (44.4%), the incidence of pancreatic fistula in two groups was statistically significant(P<0.05).Conclusion:The retention or removal of the spleen has little impact on postoperative complications of the gastric cancer patients combined distal pancreatectomy, the operative methods can be chosen according to the patient specific condition. In the pancreatic stump handling, incidence of pancreatic fistula is relatively lower in handmade group.