目的：系统性评价腹腔镜下保留脾脏的胰体尾切除术在胰体尾部肿瘤治疗中的临床疗效。方法：检索多个国内外文献数据库，根据纳入排除标准，筛选出符合要求的文献，提取数据并进行文献质量评价，应用RevMan 5.3软件进行Meta分析。结果：共纳入13篇文献，总计814例患者，其中行腹腔镜下保留脾脏的胰体尾切除术399例，行腹腔镜下胰体尾联合脾脏切除术415例。Meta分析结果显示，腹腔镜下保留脾脏的胰体尾切除术患者的手术时间（SMD=-0.79，95% CI=-1.55~-0.03，P=0.04）、术中失血量（SMD=-1.00，95% CI=-1.76~-0.24，P=0.01）及住院时间（SMD=-0.77，95% CI=-1.34~-0.21，P=0.008）均明显少于腹腔镜下胰体尾联合脾脏切除术患者；两组患者术后并发症发生率（OR=0.83，95% CI=0.63~1.10，P=0.19）及再次手术治疗率（OR=1.54，95% CI=0.52~4.59，P=0.44）差异均无统计学意义。结论：腹腔镜下保脾胰体尾切除术治疗胰体尾部肿瘤有较好的临床疗效，不会增加术后并发症发生率。
Meta-analysis of laparoscopic spleen-preserving distal pancreatectomy for tumors of pancreatic body and tail
Objective: To investigate the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy in treatment of tumors of the body and tail of the pancreas. Methods: By searching several English and Chinese databases, the eligible studies were selected through a screening process against defined inclusion and exclusion criteria. After data extraction and quality evaluation, Meta-analysis was performed by Manager 5.3 software. Results: Thirty studies were included involving 814 patients, of whom, 399 cases underwent laparoscopic distal pancreatectomy with spleen preservation and 415 cases underwent laparoscopic distal pancreatectomy with splenectomy. Results of the Meta-analysis showed that in patients undergoing laparoscopic spleen-preserving distal pancreatectomy compared with those undergoing laparoscopic distal pancreatectomy with splenectomy, the operative time (SMD=–0.79, 95% CI=–1.55––0.03, P=0.04), intraoperative blood loss (SMD=–1.00, 95% CI=–1.76––0.24, P=0.01) and length of hospital stay (SMD=–0.77, 95% CI=–1.34––0.21, P=0.008) were significantly reduced; no statistical differences were noted in the incidence of postoperative complications (OR=0.83, 95% CI=0.63–1.10, P=0.19) and reoperation rate (OR=1.54, 95% CI=0.52–4.59, P=0.44) between the two groups of patients. Conclusion: Laparoscopic spleen-preserving distal pancreatectomy has better clinical efficacy in treatment of tumors of the body and tail of the pancreas without increasing the incidence of postoperative complications.