Objective To explore the methods, clinical effects, and application value of laparoscopic splenectomy combined with pericardial devascularization.
Methods The clinical data of 23 patients with liver cirrhosis and portal hypertension who performed laparoscopic splenectomy combined with pericardial devascularization between july 2009 and july 2012 in our hospital were analyzed retrospectivly.
Results In 23 cases, 2 cases were converted laparotomy due to bleeding, 21 cases were successfully performed laparoscopic splenectomy combined with pericardial devascularization. The operative time was 230-380 minutes (average 290 minutes). The intraoperative blood loss was 300-1 500 mL (average 620 mL). The postoperative fasting time was 1-3 days (average 2 days). The postoperative hospital stay was 8-14 days (average 10 days).
Conclusion Laparoscopic splenectomy combined with pericardial devascularization is a feasible, effective, and safe procedure as well as minimally invasive hence is applicable for patients with portal hypertension and hypersplenism.
Citation:
HE Xinxin,LUO Hanchuan,CHEN Peisheng,LIU Shaoping. Application of Laparoscopic Splenectomy Combined with Pericardial Devascularization in Treatment of Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(7): 772-775. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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王卫东, 陈小伍, 冯家立, 等. 腹腔镜脾切除联合贲门周围血管离断术2例报告[J]. 中国微创外科杂志, 2008, 8(1): 83-84.
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Anegawa G, Kawanaka H, Uehara H, et al. Effect of laparoscopic splenectomy on portal hypertensive gastropathy in cirrhotic patients with portal hypertension[J]. J Gastroenterol Hepatol, 2009, 24(9): 1554-1558.
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3. |
Wang Y, Zhan X, Zhu Y, et al. Laparoscopic splenectomy in portal Hypertension:a single-surgeon 13-year experience[J]. Surg Endosc, 2010, 24(5): 1164-1169.
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4. |
刘清波, 王卫东, 吴志强, 等. Ligasure血管闭合系统在腹腔镜脾功能亢进脾切除术中的应用(附28例报告)[J]. 腹腔镜外科杂志, 2010, 15(4):286-288.
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Zheng X, Liu Q, Yao Y. Laparoscopic splenectomy and esopha-gogastric devascularization is a safe, effective, minimally invasivealternative for the treatment of portal hypertension with refractory variceal bleeding[J]. Surg Innov, 2013, 20(1): 32-39.
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甄作均, 陈焕伟, 蔡云峰, 等. 手助腹腔镜脾切除联合门奇静脉断流术[J]. 中国微创外科杂志, 2006, 6(6):436-437.
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胡三元. 腹腔镜脾切除术[J]. 腹腔镜外科杂志, 2009, 14(5):321-322.
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贾忠, 王许安, 封光华. 腹腔镜下门脉高压治疗现状及其展望[J]. 医学研究杂志, 2008, 37(11):12-14.
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胡三元, 陈波, 王可新, 等. 后外侧入路腹腔镜脾切除术:附37例报告[J]. 中华肝胆外科杂志, 2007, 13(5): 309-310.
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张雪峰, 金红旭, 李瑾, 等. 手助腹腔镜下脾切除门奇断流术(附12例报告)[J]. 消化外科, 2004, 3(4): 247-249.
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彭淑牖, 彭承宏, 陈力, 等. 避免损伤胰尾的巨脾切除术―二级脾蒂离断法[J]. 中国实用外科杂志, 1999, 19(12):758-759.
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王先法, 蔡秀军, 李伟, 等. 腹腔镜脾切除治疗特发性血小板减少性紫癜的疗效观察[J]. 中华医学杂志, 2004, 84(8):653-655.
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甄作均, 陈焕伟, 苏树英, 等. 腹腔镜脾切除术(附20例报告)[J]. 中国内镜杂志, 2004, 10(5): 84-85.
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蔡秀军, 梁霄, 虞洪, 等. 腹腔镜下二级脾蒂离断法脾脏切除术[J]. 中国实用外科杂志, 2003, 23(11):687.
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15. |
谭敏, 吴志棉, 迕羲彦, 等. 腹腔镜技术在脾脏切除术中的应用[J]. 中华外科杂志, 2001, 39(8): 599-601.
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16. |
段鑫, 何涛, 郑直, 等. 完全腹腔镜下脾切除联合贲门周围血管离断术的临床应用[J]. 中华普通外科杂志, 2010, 25(9): 702-705.
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洪得飞, 郑雪咏, 严力锋, 等. 免切割闭合器完全腹腔镜巨脾切除联合责门周围血管离断术[J]. 中国微创外科杂志, 2008, 8(1): 2l-23.
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Nagem RG, Petroianu A. Subtotal splenectomy for splenic abscess[J]. Can J Surg, 2009, 52(4): E91-E92.
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姚永良, 杨卫平, 邱伟华. 门静脉高压症外科治疗现状各展望[J]. 中国现代普通外科进展, 2009, 12(3): 234-237.
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赵玉沛, 姜洪池. 普通外科学[M]. 北京:人民卫生出版社, 2008:399-419.
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杨镇. 选择性贲门周围血管离断术的解剖基础和操作要点[J]. 外科理论与实践, 2006, 11(3): 188-189.
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22. |
谢敏, 曹亚娟, 潘一明, 等. 选择性断流术治疗门静脉高压症217例[J]. 世界华人消化杂志, 2008, 16(17): 1938-1941.
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胡虞乾, 莫瑞祥, 杨威, 等. 肝硬化门脉高压症断流术后再出血多因素分析[J]. 广西医学, 2002, 24(3): 332-333.
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24. |
孙跃明. 完全腹腔镜脾切除加门奇静脉断流术与开腹手术的临床对照研究[J]. 腹腔镜外科杂志, 2009, 14(5): 337-339.
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ShaIniyeh A, Schrenk P, Tulipan L, et a1. A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery[J]. Surg Endosc, 2002, 16(5): 812-813.
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- 1. 王卫东, 陈小伍, 冯家立, 等. 腹腔镜脾切除联合贲门周围血管离断术2例报告[J]. 中国微创外科杂志, 2008, 8(1): 83-84.
- 2. Anegawa G, Kawanaka H, Uehara H, et al. Effect of laparoscopic splenectomy on portal hypertensive gastropathy in cirrhotic patients with portal hypertension[J]. J Gastroenterol Hepatol, 2009, 24(9): 1554-1558.
- 3. Wang Y, Zhan X, Zhu Y, et al. Laparoscopic splenectomy in portal Hypertension:a single-surgeon 13-year experience[J]. Surg Endosc, 2010, 24(5): 1164-1169.
- 4. 刘清波, 王卫东, 吴志强, 等. Ligasure血管闭合系统在腹腔镜脾功能亢进脾切除术中的应用(附28例报告)[J]. 腹腔镜外科杂志, 2010, 15(4):286-288.
- 5. Zheng X, Liu Q, Yao Y. Laparoscopic splenectomy and esopha-gogastric devascularization is a safe, effective, minimally invasivealternative for the treatment of portal hypertension with refractory variceal bleeding[J]. Surg Innov, 2013, 20(1): 32-39.
- 6. 甄作均, 陈焕伟, 蔡云峰, 等. 手助腹腔镜脾切除联合门奇静脉断流术[J]. 中国微创外科杂志, 2006, 6(6):436-437.
- 7. 胡三元. 腹腔镜脾切除术[J]. 腹腔镜外科杂志, 2009, 14(5):321-322.
- 8. 贾忠, 王许安, 封光华. 腹腔镜下门脉高压治疗现状及其展望[J]. 医学研究杂志, 2008, 37(11):12-14.
- 9. 胡三元, 陈波, 王可新, 等. 后外侧入路腹腔镜脾切除术:附37例报告[J]. 中华肝胆外科杂志, 2007, 13(5): 309-310.
- 10. 张雪峰, 金红旭, 李瑾, 等. 手助腹腔镜下脾切除门奇断流术(附12例报告)[J]. 消化外科, 2004, 3(4): 247-249.
- 11. 彭淑牖, 彭承宏, 陈力, 等. 避免损伤胰尾的巨脾切除术―二级脾蒂离断法[J]. 中国实用外科杂志, 1999, 19(12):758-759.
- 12. 王先法, 蔡秀军, 李伟, 等. 腹腔镜脾切除治疗特发性血小板减少性紫癜的疗效观察[J]. 中华医学杂志, 2004, 84(8):653-655.
- 13. 甄作均, 陈焕伟, 苏树英, 等. 腹腔镜脾切除术(附20例报告)[J]. 中国内镜杂志, 2004, 10(5): 84-85.
- 14. 蔡秀军, 梁霄, 虞洪, 等. 腹腔镜下二级脾蒂离断法脾脏切除术[J]. 中国实用外科杂志, 2003, 23(11):687.
- 15. 谭敏, 吴志棉, 迕羲彦, 等. 腹腔镜技术在脾脏切除术中的应用[J]. 中华外科杂志, 2001, 39(8): 599-601.
- 16. 段鑫, 何涛, 郑直, 等. 完全腹腔镜下脾切除联合贲门周围血管离断术的临床应用[J]. 中华普通外科杂志, 2010, 25(9): 702-705.
- 17. 洪得飞, 郑雪咏, 严力锋, 等. 免切割闭合器完全腹腔镜巨脾切除联合责门周围血管离断术[J]. 中国微创外科杂志, 2008, 8(1): 2l-23.
- 18. Nagem RG, Petroianu A. Subtotal splenectomy for splenic abscess[J]. Can J Surg, 2009, 52(4): E91-E92.
- 19. 姚永良, 杨卫平, 邱伟华. 门静脉高压症外科治疗现状各展望[J]. 中国现代普通外科进展, 2009, 12(3): 234-237.
- 20. 赵玉沛, 姜洪池. 普通外科学[M]. 北京:人民卫生出版社, 2008:399-419.
- 21. 杨镇. 选择性贲门周围血管离断术的解剖基础和操作要点[J]. 外科理论与实践, 2006, 11(3): 188-189.
- 22. 谢敏, 曹亚娟, 潘一明, 等. 选择性断流术治疗门静脉高压症217例[J]. 世界华人消化杂志, 2008, 16(17): 1938-1941.
- 23. 胡虞乾, 莫瑞祥, 杨威, 等. 肝硬化门脉高压症断流术后再出血多因素分析[J]. 广西医学, 2002, 24(3): 332-333.
- 24. 孙跃明. 完全腹腔镜脾切除加门奇静脉断流术与开腹手术的临床对照研究[J]. 腹腔镜外科杂志, 2009, 14(5): 337-339.
- 25. ShaIniyeh A, Schrenk P, Tulipan L, et a1. A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery[J]. Surg Endosc, 2002, 16(5): 812-813.