完全腹腔镜脾切除加门奇静脉断流术治疗门静脉高压症

目的:探讨完全腹腔镜脾切除加门奇静脉断流术治疗门静脉高压症的可行性、安全性和优缺点。方法:回顾分析我院2005年1月至2007年12月收治的12例肝硬化门静脉高压症合并脾功能亢进、上消化道出血(呕血或黑便史)患者的临床资料,12例均施行完全腹腔镜脾切除加门奇静脉断流术。结果:12例患者均在腹腔镜下完成手术,平均手术时间210min,术中平均出血340ml,平均住院12d,术后随访3~36个月。无一例发生再出血。结论:完全腹腔镜脾切除加门奇静脉断流术安全可行,疗效确切,是值得临床推广的治疗门静脉高压症的微创手术方式。

Total laparoscopic splenectomy plus esophagogastric devascularization in the treatment of portal hypertension

Objective:To evaluate the feasibility and safety of total laparoscopic splenectomy plus esophagogastric devascularization in the treatment of portal hypertension.Methods:The patients suffering portal hypertension with the history of upper gastrointestinal tract hemorrhage underwent laparoscopic splenectomy plus esophagogastric devascularization from January 2005 to December 2007.The follow-up was from three months to three years,and the data was retrospectively analyzed.Results:The procedures were successful in all cases without conversion to open surgery.The mean operative time,blood loss in operation and postoperative hospitalization were 210min,340ml and 12d respectively.There was no mortality and serious postoperative complications.No bleeding event occured postoperatively.Conclusions:Total laparoscopic splenectomy plus esophagogastric devascularization is feasible,safe and less invasive in treatment of patients with portal hypertension,which is worth gereralized.