腹腔镜脾切除术脾蒂处理方法探讨

目的探计腹腔镜脾切除术(laproscopic splenectomy,LS)中处理脾蒂的方法。方法回顾性分析36例腹腔镜脾切除手术病例(包括16例腹腔镜下脾切除联合断流手术)的临床资料。了解脾蒂处理的方法及技巧。结果36例病人中有1例中转开腹,35例均顺利完成腹腔镜脾切除术或腹腔镜脾切除联合断流手术,19例腹腔镜脾切除平均手术时间为165min,术中平均失血87mL,术后平均禁食时间1.5d,术后平均住院时间6d。16例腹腔镜脾切除联合断流手术平均手术时间268min,术中平均失血800mL,手术后平均禁食时间为2.5d,手术后平均住院时间8d。结论腹腔镜脾切除及腹腔镜脾切除联合断流手术是安全且效果良好的手术,手术成功的关键是术中仔细操作,控制脾蒂,防止大出血。

Techniques of managing spleen pedicel in laparoscopic splenectomy

Objective To study techniques of managing spleen pedicel in laparoscopic splenectomy.Method We retrospective analyzed 36 cases of LS(including 16 cases of laparoscopic splenectomy associate with devascularization.)clinical data and studied methods and techniques of managing spleen pedicel.Result Total 36 cases,among them 1 patient was converted to open operation due to massive bleeding splenic artery,and the other 35 patients were completed(laparoscopic splenectomy or laparoscopic splenectomy associate with devascularization.)very smoothly without any complication.19 cases laparoscopic splenectomy average operation period was 165.0 min.Average blood loss was 87 mL,and post-operation fasting period was average 1.5 day,after LS average hospitalization period 6 days.16 cases of laparoscopic splenectomy associate with devascularization average operation time was 268 min,and blood loss was 800 mL,fasting 2.5 days after operation.hospitalization period 8 days after operation.Conclusion Laparoscopic splenectomy and laparoscopic splenectomy associate with devascularization is feasible,effective,and safe.Surgeons need advanded technical skills and equipment manage herorrhage.