全腹腔镜贲门周围血管离断术治疗门静脉高压症  

Effectiveness of total laparoscopic pericardia vascular disconnection for portal hypertension

作　　者：邓小斌 程剑锋 方汉初 聂磊 翟亚辉 Deng Xiao- bin;Cheng Jianfeng;Fang Hanchu;Nie Lei;Zhai Yahui.(Department of General Surgery, Xiaochang First People＇s Hospital, Xiaogan 432900, Chin)

机构地区：[1]孝昌县第一人民医院普外科,湖北孝感432900

出　　处：《腹部外科》2018年第2期104-107,F0002,共5页Journal of Abdominal Surgery

摘　　要：目的对比全腹腔镜与开腹贲门周围血管离断术治疗门静脉高压症的疗效。方法回顾性分析孝昌县第一人民医院普外科2014年2月至2016年8月收治的门静脉高压症并伴有肝硬化、食管胃底静脉曲张,需行贲门周围血管离断术的80例病人的临床资料,其中采用腹腔镜手术治疗37例,纳入腹腔镜组;采用开腹手术治疗43例,纳入开腹组。对比术中情况、术后恢复情况、并发症发生情况以及复发率。结果两组术中出血量、术后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)相比较,差异均无统计学意义(均P>0.05)。腹腔镜组术后恢复进食时间、术后住院时间短于开腹组,医院感染发生率、并发症发生率低于开腹组,手术时间长于开腹组,差异均有统计学意义(均P<0.05)。随访时间为13~43个月,两组均未见复发病人。结论全腹腔镜贲门周围血管离断术治疗门静脉高压症可能导致手术时间延长,但有助于降低并发症发生风险,缩短住院时间。Objective To compare effectiveness of total laparoscopic and open pericardia vascular disconnection for portal hypertension.Methods A total of 80 cases diagnosed as portal hypertension complicated with hepatic cirrhosis and esophagus-gastric fundus varicose vein,admitted from Feb.2014 to Aug.2016,were analyzed retrospectively.Among them,37 cases were given total laparoscopic pericardia vascular disconnection as laparoscopic group,and 43 cases were given open pericardia vascular disconnection as open group.The intra-and post-operative status,complications and recurrence rate were observed and compared between two groups.Results There was no statistically significant difference in intra-operative blood loss and the post-operative levels of ALT and AST between two groups（P〉0.05）.The time of gastrointestinal recovery and the post-operative hospital stays were shorter,the incidence of nosocomial infection and the rate of complications were lower,and the operative duration was longer in laparoscopic group than in open group（P〈0.05）.There was no recurrence in both two groups during the follow-up period of 13 to 43 months.Conclusions Although the surgical intervention of laparoscopic pericardia vascular disconnection may be delayed in the operative duration,it can decrease the rate of complication and shorten the post-operative hospital stays.

关 键 词：腹腔镜手术 门静脉高压症 贲门周围血管离断术 

分 类 号：R657.3[医药卫生—外科学]