腹腔镜；脾切除术；脾蒂_____腹腔镜；脾切除术；脾蒂

腹腔镜门脉高压症巨脾切除术脾蒂的处理体会

http://www.100md.com 《腹腔镜外科杂志》 2006年第5期

腹腔镜；脾切除术；脾蒂,,腹腔镜；脾切除术；脾蒂,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨手助腹腔镜下巨脾切除的脾蒂处理方法和技术。方法：2003年2月~2006年3月共完成手助腹腔镜门脉高压症巨脾切除术33例。脾蒂的处理方法如下：直线切割缝合器23例，直视下结扎4例，血管闭合器(LigaSure)2例，钛夹2例，腔镜下结扎2例。结果：33例手术全部成功处理脾蒂,未发生脾蒂大出血。手术时间150~260min，平均190min。术中出血100~2 000ml，平均490ml。切除脾重500~2 000g，平均910g。术后32例恢复顺利，1例因肝功能衰竭死亡。结论：腔镜下巨脾切除术脾蒂处理十分关键，直视下结扎和应用直线切割缝合器处理脾蒂最为安全、有效。

    【关键词】腹腔镜；脾切除术；脾蒂

    The experiences of splenic pedicle lagation in patients with megalosplena using handassisted laparoscopic surgery

    ZHANG Xuefeng,JIN Hongxu,LI Jin，et al.

    General Hospital of Shenyang Military Region,Shenyang 110016,China

    【Abstract】 Objective:To explore the technique and methods of splenic pedicle lagation in patients with megalosplena in handassisted laparoscopic surgery(HALS).Methods:33 patients with portal hypertension were performed handassisted laparoscopic splenectomy.The methods of splenic pedicle lagation with Endocutter were used in 23 cases,lagation under direct vision were in 4 cases, using LigaSure were in 2 cases,using titanium clamp were in 2 cases and lagation under laparoscopy were 2 cases.Results:The operation was completed successfully and there was no massive hemorrhage of splenic pedicle.The mean operative time was 190(150260) minutes,mean estimated blood loss was 490(1002 000)ml,mean weight of spleen was 910(5002 000)g.The patients were recovered rapidly but one patient was died of hepatic failure after operation.Conclusions:It′s critital of the splenic pedicle lagation and the methods of splenic pedicle lagation with Endocutter or lagation under direct vision are most safety and effective. ......

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