急诊腹腔镜脾切除术在外伤性脾破裂中的应用

目的探讨急诊腹腔镜脾切除术（1aparoscopic splenectomy，LS）治疗外伤性脾破裂的可行性。方法回顾分析我院2010年11月-2012年3月因外伤性脾破裂行急诊Ls20例的临床资料，根据脾蒂的不同类型，18例用Endo．GIA施行一级脾蒂离断，2例用Hem-o-lok施行二级脾蒂离断。结果20例手术均成功，无中转开腹，手术时间80-180min，平均110min，术中腹腔内有出血约700-1，2500ml，平均1300ml。术后无明显并发症发生。20例术后随访6个月，所有患者10天基本恢复正常生活，15—45天恢复正常工作，无严重术后并发症。结论急诊Ls治疗外伤性脾破裂可行。

Emergency Laparoscopic Splenectomy for Traumatic Splenic Rupture

Objective To discuss the feasibility of emergency laparoscopic splenectomy （LS） for traumatic splenic rupture. Methods A retrospective analysis was made on 20 cases of traumatic splenic rupture, who received emergency LS from November 2010 to March 2010. Based on the type of splenic pedicle, 18 of the patients Underwent resection of primary splenic pedicle with Endo- GIA, and the other two received resection of secondary splenic pedicle with Hem-o-lok. Results The procedure was completed in all the 20 cases without conversion to open surgery. The mean operation time was 110 rain （ranged from 80 to 180 rain） , during the operation, the mean intra-abdominal blood loss was 1300 ml （ranged from 700 to 2500 ml）. No severe complications occurred after the surgery. The patients were followed up for 6 months, during which all the patients recovered daily life in 10 days, and were back to work in 15 to 45 days. Conclusion Emergency LS is feasible for traumatic splenic rupture.