腹腔镜脾切除术21例临床分析

目的：探讨腹腔镜脾切除术的安全性及临床效果。方法：回顾性分析21例腹腔镜脾切除术患者（16例肝炎后肝硬化及3例脾梗死,1例脾包虫病,1例血吸虫性肝硬化）的临床资料。结果：21例中2例中转开腹,19例成功完成腹腔镜脾切除术,其中1例行腹腔镜下脾大部切除术。平均手术时间为150min,平均术中失血485ml,术后24～48h胃肠蠕动恢复,术后平均住院时间为12d。结论：经过选择的患者行腹腔镜脾切除术安全可行,除血液系统疾病外还适用于肝硬化患者中需行脾切除者及脾脏本身病变者。

The clinical analysis of laparoscopic splenectomy:with a report of 21 cases

Objective:To explore the safety and clinical effects of laparoscopic splenectomy.Methods:The Clinical data of 21 cases with laparoscopic splenectomy were analysed retrospectively.Among 21 cases,there were 16 cases with liver cirrhosis,3 cases with splenic infarction,1 case with hydatid disease of spleen,and 1 case with liver cirrhosis of schistusoma japonicum.Results:Two cases were converted to open splenectomy,19 cases successfully underwent laparoscopic splenectomy,including a subtotal laparoscopic splenectomy.The mean operative time was 150min,the mean blood loss was 485ml,the posterative gastrointestinal peristalsis time was from 24 to 48 hours.The mean hospitalization was 12 days after operation.conclusions:In selected patients,laparoscopic splenectomy is safe.Besides the patients with hematonosis who require splenectomy,it is also applied to those patients with liver cirrhosis and sufferred from splenic diseases.