腹腔镜脾切除联合贲门周围血管离断术治疗肝硬化门静脉高压症的近期临床结果  

Short-term clinical outcome of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension in liver cirrhosis

作　　者：崔然 叶伦河 王旭菁 王永坤[1] 张琪祺 王恺京[1] 王明[1] 戴陈新[1] 杨鹿笛 董春秀 陈波[1] CUI Ran;YE Lunhe;WANG Xujing;WANG Yongkun;ZHANG Qiqi;WANG Kaijing;WANG Ming;DAI Chenxin;YANG Ludi;DONG Chunxiu;CHEN Bo(Department of Hepatopancreatobiliary Surgery,East Hospital Affiliated Tongji University,Shanghai 200123,China)

机构地区：[1]同济大学附属东方医院肝胆胰外科,上海200123

出　　处：《外科理论与实践》2021年第3期221-225,共5页Journal of Surgery Concepts & Practice

基　　金：上海市科学技术委员会科技计划项目(20Y11912100);上海市卫生健康委员会科研课题(20204Y0302);上海市浦东新区科技发展基金民生科研专项资金医疗卫生项目(PKJ2020-Y20)。

摘　　要：目的:探讨腹腔镜脾切除联合贲门周围血管离断术治疗门静脉高压症的近期结果和安全性。方法:回顾性分析2018年9月至2020年12月间我院行腹腔镜脾切除联合贲门周围血管离断术治疗的23例临床资料。选择同时、同科室临床病理基线相当的开腹脾切除联合贲门周围血管离断术13例临床资料作对比。结果:腹腔镜手术组较传统开腹镜组病人出血量相对较少、手术时间较长、肛门排气较早、恢复进食较早。两组术后住院时间、术后并发症(出血、胸腔积液、深静脉血栓、胃瘫、切口感染)差异均无统计学意义(P>0.05)。结论:腹腔镜脾切除联合贲门周围血管离断术有效治疗肝硬化门静脉高压症具有术中出血量少、术后恢复进食时间较早和安全的优势,近期结果与开腹手术相似。Objective To investigate the short-term outcome and safety of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension.Methods A retrospective analysis was done with clinical data of 23 patients who underwent laparoscopic splenectomy combined with peripheral cardia disconnection in our hospital from September 2018 to December 2020.Comparison was performed using the clinical data of 13 cases with the method of open surgery,which were comparable to the clinical pathological baseline.Results Less blood loss,longer operative time,and earlier both exhaust time and feeding time were found in the patients of laparoscopic group compared with those in open group.There were no statistically significant differences in postoperative hospital stay and postoperative complications including bleeding,pleural effusion,deep vein thrombosis,gastroparesis,and incision infection between two groups(P>0.05).Conclusions Laparoscopic splenectomy combined with peripheral cardia disconnection can treat portal hypertension which is safe,less blood loss,early postoperative feeding and the short-term outcome similar to open surgery.

关 键 词：腹腔镜 脾切除 门静脉高压症 近期结果 

分 类 号：R657.34[医药卫生—外科学]