完全腹腔镜脾切除术16例报告

目的:探讨腹腔镜脾切除术的可行性及安全性。方法:回顾分析2010年3月至2011年2月16例完全腹腔镜脾切除术的临床资料。结果:16例均成功完成手术;术中未发生意外损伤周围脏器或难以控制的大出血从而被迫中转开腹,无手术死亡病例;手术时间60～210 min,平均140 min;术中出血量20～400 ml,平均163 ml。3例脾外伤患者回输自体血800～1500 ml,3例肝硬化脾功能亢进症患者因术前贫血与凝血异常分别输红细胞悬液600 ml、冰冻血浆400 ml;1例脾血管瘤患者术后并发脾窝包裹性积液,在B超引导下穿刺抽液治愈;1例脾功能亢进症患者术后并发门静脉系统血栓形成,予以融栓抗凝治疗恢复。均于术后第2天下床活动,24 h拔除胃管并进全流质饮食,术后住院5～14 d,平均7.3 d。结论:完全腹腔镜脾切除术安全可行,具有微创、美容、患者康复快等优点,值得在有条件的单位推广应用。

The clinical analysis of laparoscopic splenectomy : a report of 16 cases

Objective:To explore the feasibility and safety of laparoscopic splenectomy.Methods:The clinical data of 16 cases of laparoscopic splenectomy From Mar.2010 to Feb.2011 were analyzed retrospectively.Results:All the operation was successfully performed.There was no surrounding organs injury and uncontrol bleeding occurred,no case was transferred to opening splenectomy.One case with encapsulated effusion in abdominal cavity was cured by aspiration and draining under the Guidance of B-mode Ultrasonography.One case with portal venous thrombosis was resumed by Anticoagulation and thrombolysis treatment.Conclusions:Laparoscopic splenectomy is safe,reliable,minor trauma and beautiful small abdominal incision,quicker recovery and worth promotion in the conditional hospitals.