腹腔镜下二级脾蒂游离原位脾切除术20例分析  

In-situ secondary splenic pedicle transaction in laparoscopic splenectomy: analysis of 20 cases

作　　者：张勇[1] 郭子健[1] 曹华祥[1] 周俊晶[1] 戴赛民[1] 赵长勇[1] 鱼海峰[1] 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)普外科,214062

出　　处：《中华普外科手术学杂志（电子版）》2015年第6期80-81,共2页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨二级脾蒂游离在腹腔镜下原位脾切除术中的应用价值。方法 2011年1月至2015年3月对20例患者进行腹腔镜下原位游离二级脾蒂切除脾脏。结果 19例患者成功游离二级脾蒂行原位脾切除术,1例患者应用直线切割闭合器离断脾蒂行原位脾切除术。19例患者术中出血（310±11）ml。术后未出现继发感染、胰漏、再出血等并发症。手术时间（68±21）min。术后72 h内拔除脾窝引流管。术后9~15 d出院,住院时间（10.8±1.2）d。所有患者术后随访6个月,10例出现血小板增高,予以口服阿司匹林肠溶片处理,所有患者均未出现肠梗阻、门静脉血栓形成等并发症。结论二级脾蒂游离法在腹腔镜下原位切除术中的应用是安全可行的。Objective To investigate the value of in-situ secondary splenic pedicle trisection method in laparoscopic splenectomy. Methods From January 2011 to March 2015,20 patients were given laparoscopic splenectomy with in-situ secondary splenic pedicle transaction. Results Laparoscopic splenectomy with secondary splenic pedicle transaction was successfully performed in 19 patients,whereas an Endo-GIA was used in 1 patient. Of the 19 patients,operative blood loss was（ 310 ± 11） ml. No postoperative secondary infection,pancreatic leakage,and other complications occurred. The operation time was（ 68 ± 21） min. The drainage of the splenic fossa was removed in 72 hours after operation. Postoperative hospital stay was 9-15 days after operation（ 10. 8 ± 1. 2） days. All of the 20 patients were followed up for 6months and ten of them have thrombocytosis,which was treated with oral aspirin. No intestinal obstruction and portal vein thrombosis were observed in all the 20 patients. Conclusion In-situ secondary splenic pedicle trisection is safe and feasible in laparoscopic splenectomy.

关 键 词：脾疾病 脾切除术 腹腔镜检查 

分 类 号：R657.6[医药卫生—外科学]