腹腔镜选择性断流术治疗门静脉高压症的临床体会  

Clinical experience of laparoscopic splenectomy plus selective pericardial devascularization for portal hypertension

作　　者：李国林[1] 周泉波[1] 陈汝福[1] 

机构地区：[1]中山大学孙逸仙纪念医院胆胰外科,广州510120

出　　处：《腹部外科》2015年第6期399-402,共4页Journal of Abdominal Surgery

摘　　要：目的探讨腹腔镜脾切除联合选择性贲门周围血管离断术在治疗门静脉高压症的手术疗效以及手术技巧。方法回顾性分析2010年3月至2014年12月开展的31例腹腔镜脾切除联合选择性贲门周围血管离断术及38例传统开腹手术病人的临床资料，比较组间病人围手术期相关临床资料的差异。结果两组手术均顺利完成，围手术期未出现严重手术并发症。腔镜组的平均手术时间（283．55±59．11）min长于开腹组（272．24±73．48）min，P〉0．05。术中出血量（358．1±189．3）ml稍多于开腹组（350．0±208．9）ml，P〉0．05。而术后排气时间（34．3±9．42）h优于开腹组（43．1±13．64）h，P〈O．05，术后住院时间（11．19±4．26）d优于开腹组（13．50±3．27）d，P〈0．01。Objective To discuss the surgical effect and skills of laparoscopic splenectomy plus selective pericardial devascularization for portal hypertension. Methods The clinical data of 31 cases undergoing laparoscopic splenectomy plus selective pericardial devascularization （laparoscopic group） and 38 cases subject to traditional laparotomy （laparotomy group ） were retrospectively analyzed, and the perioperative parameters were compared between the two groups. Results All operations were performed successfully, and no severe complications occurred perioperatively. In laparoscopic group and laparotomy group, the mean operative time was 283. 55 ± 59. 11 and 272. 24 ±73. 48 min （P〈 0. 05）, the mean blood loss was 358. 1 ± 189. 3 and 350. 0 ± 208. 9 mL （P〉0. 05）, the mean time of bowel function recovery was 34. 3 ± 9. 42 and 43. 1 ± 13. 64 h （P〈0. 05）, and postoperative hospital stay was 11.19 ± 4. 26 and 13.50 ± 3. 27 d （P〈0. 01）, respectively. Conclusions Laparoscopic splenectomy plus selective pericardial devascularization is safe and effective, and it is worthy of popularization and application.

关 键 词：腹腔镜脾切除 选择性贲门周围血管离断术 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]