腹腔镜脾切除联合贲门周围血管离断术在门静脉高压症中的应用

目的探讨腹腔镜脾切除联合贲门周围血管离断术的手术方法、临床效果及应用价值。方法回顾性分析2009年7月至2012年7月期间,笔者所在医院科室施行的腹腔镜下脾切除加贲门周围血管离断术治疗肝硬变门静脉高压症23例患者的临床资料。结果 23例患者中,有2例中转开腹,21例顺利完成腹腔镜脾切除加贲门周围血管离断术。手术时间230～380 min,平均290 min;术中失血量300～1 500 mL,平均620 mL;术后禁食1～3 d,平均2 d;术后住院时间8～14 d,平均10 d。结论腹腔镜脾切除加贲门周围血管离断术安全可行,对机体创伤小,术后并发症少,疗效确切。

Application of Laparoscopic Splenectomy Combined with Pericardial Devascularization in Treatment of Portal Hypertension

Objective To explore the methods,clinical effects,and application value of laparoscopic splenectomy combined with pericardial devascularization.Methods The clinical data of 23 patients with liver cirrhosis and portal hypertension who performed laparoscopic splenectomy combined with pericardial devascularization between july 2009 and july 2012 in our hospital were analyzed retrospectivly.Results In 23 cases,2 cases were converted laparotomy due to bleeding,21 cases were successfully performed laparoscopic splenectomy combined with pericardial devascularization.The operative time was 230-380 minutes（average 290 minutes）.The intraoperative blood loss was 300-1 500 mL（average 620 mL）.The postoperative fasting time was 1-3 days（average 2 days）.The postoperative hospital stay was 8-14 days（average 10 days）.Conclusion Laparoscopic splenectomy combined with pericardial devascularization is a feasible,effective,and safe procedure as well as minimally invasive hence is applicable for patients with portal hypertension and hypersplenism.