全腹腔镜下“隧道法”原位脾切除术  

Laparoscopic splenectomy with behind splenic hilus tunnel-building technique

作　　者：李金政[1] 游科[1] 涂兵[1] 龚建平[1] 刘作金[1] 

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010

出　　处：《中国普外基础与临床杂志》2018年第3期338-341,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨隧道法用于全腹腔镜下脾切除术的手术技巧及可行性。方法对重庆医科大学附属第二医院2017年12月收治的1例乙肝后肝硬变合并脾大、脾功能亢进患者资料进行总结。结果该患者在全腹腔镜下采用自下而上、从前往后、由浅入深的手术入路,充分暴露并显示胰腺尾部(脾蒂)上、下极,建立隧道后切除脾脏。手术时间70 min,术中出血约50 mL,术后第5天出院。结论隧道法用于全腹腔镜下脾切除术安全、有效。Objective To discuss surgical skills and clinical value of laparoscopic splenectomy with behind splenic hilus tunnel-building technique. Method The clinical data of 1 patient with HBV-related hepatic cirrhosis combined splenomegaly and hypersplenism treated in the Second Affiliated Hospital of Chongqing Medical University was discussed and summarized. Results The patient underwent the laparoscopic splenectomy with surgical approach of from bottom to top, front to back, and shallow to deep. The key point of the tunnel-building technique was fully exposed the upper and lower poles of the splenic pedicle. The operative time was 70 min, the intraoperative blood loss was 50 mL, and the discharge time was 5 d after operation. Conclusion Laparoscopic splenectomy with behind splenic hilum tunnel-building technique is safe and feasible, especially for beginners.

关 键 词：腹腔镜脾切除术 隧道法 

分 类 号：R657.6[医药卫生—外科学]