双镜联合治疗门脉高压的临床应用

目的：探讨双镜联合治疗门脉高压的可行性。方法对15例门脉高压患者行腹腔镜下完成脾切除、门奇断流术，同时应用胃镜直视下缝合结扎胃底曲张静脉血管。结果15例均顺利完成手术。手术时间1.5-2.3（1.62±0.78）h，术中出血10-210（82.57±63.53）ml，术后未发生并发症。术后住院10-15 d。术后随访14例（93.3%），失访1例，随访9-36（12.3±7.8）个月，1例于术后12个月因其他疾病死亡，其他患者随访期间未见再出血。结论结合手助腹腔镜脾切除、贲门周围血管离断的微创优点，同时结合胃镜的显示与透光作用，取长补短，确切、有效地处理胃底曲张静脉，是值得推广的微创手术方法。

The clinical application of laparoscopy combined gastroscopy for the treatment of portal hypertension

Objective To discuss the feasibility of the laparoscopy combined gastroscopy which are used in the treatment of portal hypertension. Methods 15 cases of portal hypertension patients were treated by hand-assisted laparoscopic splenectomy, portal azygous vein disconnection, At the same time, with the application of gastroscopy to displayed directly to suture and ligation gastric varicose veins of the fundus of stomach. Results 15 cases were successfully completed surgery. The operation time 1.5-2.3 （1.62±0.78）h, hemorrhage during operation 10 ~210 （82.57 ±63.53）ml, No postoperative complications. Postoperative hospitalization 10-15 days. Postoperative follow-up of 14 cases （93.3%）, 1 case was lost to follow-up, Follow-up of 9-36 （12.3±7.8） months, 1 case died after 12 months because of other disease, other patients didn’t rebleeding during the follow -up period.Conclusions The advantages of hand -assisted laparoscopic splenectomy and cardiac peripheral vascular transection, combined with gastroscopy displayed directly and light transparent effect each other, exactly, effectively to deal with esophagogastric varices. The laparoscopy combined gastroscopy for the treatment of portal hypertension are worth promoting.