腹腔镜脾切除及门奇静脉断流术10例报告

目的探讨腹腔镜脾切除和门奇静脉断流术的手术方法、安全性和有效性.方法从2000年1月至2005年7月为10例肝硬化门静脉高压症继发性脾功能亢进和上消化道出血患者进行了完全腹腔下脾切除和门奇静脉断流术,其中2例加做上腹小切口、管形吻合器食管下段横断和吻合术.结果本组10例腹腔镜脾切除和门奇静脉断流术全部完成,无1例需中转开腹手术.手术时间4.5～5.5 h,出血量100～400ml,术后住院8～15 d.结论腹腔镜脾切除和门奇静脉断流术在技术上是切实可行的,对机体创伤小、疗效确定.

Laparoscopic splenectomy plus esophagogastric devascularization for the treatment of portal hypertension

Objective To evaluate the safety and efficacy of laparoscopic splenectomy plus esophagogastric devascularization for the treatment of portal hypertensive variceal bleeding and secondary hypersplenism. Methods Laparoscopic splenectomy and devascularization of the lower esophagus and upper stomach were performed in ten cirrhotic patients between January 2000 and July 2005. Esophageal transection and reanastomosis performed by a stapler at the lower end of the esophagus was added to two patients through a small accessory incision. Results The procedure was successful in all cases without conversion to open surgery. The operation time ranged from 4. 5 to 5.5 hours and the blood loss was 100- 400 ml. The postoperative hospital stay was 8 - 15 days. Conclusion Laparoscopic splenectomy and portaazygous disconnection is a feasible, effective and safe procedure as well as minimally invasive hence is applicable for patients with portal hypertension and hypersplenism.