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目的探讨腹腔镜脾切除术(laparoscopic splenectomy，LS)和腹腔镜辅助脾切除术(laparoscopic assisted splenectomy，LAS)的优缺点。方法1994～2003年共实施脾切除术43例，其中采用LAS行脾切除术13例，完全在腹腔镜下行脾切除术30例，切除副牌6例，4例同时行腹腔镜胆囊切除术。结果手术均获成功，LS术后切口感染1例，并发DIC 1例，平均手术时间160min，术中失血平均120mL，术后平均住院5．4d。LAS平均手术时间132min，术中平均失血90mL，术后平均住院8．6d。结论LS和LAS均安全可行，LAS手术时间短，术中出血少，但病人住院时间长。LS费时费事，术中出血多。

Laparoscopic splenectomy:a report 43 cases

Objective To evaluate the virtue and shortage of laparoscopic splenectomy (LS) and laparoscopic assisted splenectomy(LAS). Methods Forty-three cases were performed splenectomy between 1994 and 2003,among them 13 cases of splenectomy were performed in LAS. 30 cases of splenectomy were performed by laparoscopy completely. At the same time 6 cases of accessory splenectomy were performed,4 cases of laparoscopic cholecystectomy were performed. Results All operations were successful. In LS, 1 case had infection of incisional wound after operation, 1 case had DIC. Average operation time was 169min, average blood loss in operation was 120ml,and average hospitalization after operation was 4d. In LAS, average operation time was 132min, average blood loss in operation was 90ml, average hospitalization after operation was 8.6d. Conclusions LS and LAS are safe and feasible techniques. LAS means less operation time and less blood loss, but long hospitalization. LS means time-consuming, trouble and more blood loss.