Clinical Analysis Of Organ Function Preserving Surgery In The Treatment Of Benign And Low-grade Malignant Pancreatic Lesions

Objective: To explore the advantages and disadvantages of pancreatic surgery preserving organ function in the diagnosis and treatment of benign and low-grade malignant pancreatic diseases.Methods: the general clinical data of 299 patients with benign and low-grade malignant pancreatic lesions treated by pancreatic surgery of the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2021 were included.They were divided into pancreatic head group and pancreatic body tail group according to the lesion location.The group was divided into PD group,DPPHR group,DPS group,MSP group,en group and SPDP group according to the operation method.The collected contents included preoperative data,intraoperative data To compare the therapeutic effects of different surgical methods on benign and low-grade malignant pancreatic lesions.Results: in the pancreatic head PD group,the average maximum diameter of the tumor was(6.2 ± 2.1)cm,which was significantly larger than that in the DPPHR group(3.5 ± 0.9)cm.The difference between the two groups was statistically significant(P = 0.026).The incidence of postoperative pancreatic endocrine dysfunction in PD group was 34.5%,which was higher than 7.5% in DPPHR group(P = 0.002).Other data do not show significant differences.In the pancreatic body and tail group,there were no significant differences in age,gender,tumor size,intraoperative bleeding,postoperative hospital stay and actual hospitalization expenses between DPS group and SPDP group,MSP group and en group(P > 0.05);The operation time in DPS group was(348.7 ± 113.2)min,which was significantly shorter than that in SPDP group(451.8 ± 165.9)min.The percentage of total complications in DPS group was much higher than that in the other three groups.The incidence of pancreatic fistula in DPS group was 33.8%,which was lower than 58.3% in MSP group.The difference was statistically significant(P = 0.031).The abnormal increase rate of platelet in DPS group was 55.0%,and the other three groups were 7.6%,0% and 0% in SPDP group,0% and 0% in en group.The difference was statistically significant.Conclusion: 1.Compared with traditional PD,DPPHR has significantly less intraoperative bleeding than PD,and the incidence of pancreatic secretion dysfunction is also significantly lower than PD,but it does not show obvious advantages in operation time,control of postoperative abdominal infection,postoperative gastric spread and incidence of postoperative abdominal bleeding.2.In this study,compared with SPDP,MSP and en,traditional DPS has a significantly higher incidence of abnormal platelet elevation after operation,while SPDP and MSP lag behind traditional DPS in operation time;The incidence of pancreatic fistula in MSP was significantly lower than that in DPS,while SPDP and en did not show advantages in this regard.