吻合器贲门周围血管离断术治疗门脉高压症出血

Transabdominal gastroesophageal stapling in management of variceal bleeding in portal hypertension

[目的]评价应用吻合器贲门周围血管离断术治疗门静脉高压症并出血的临床效果。[方法]用贲门周围血管离断术治疗42例门脉高压出血患者,观察手术死亡率、再出血率、食管曲张消除率、吻合口狭窄、吻合口瘘发生率。[结果]本组手术死亡1例,术后全部达到止血效果,随访8-36个月无再出血,无吻合口瘘,吻合口狭窄2例。[结论]应用吻合器、食管下段切除再吻合术安全、有效、离断更为彻底,从而进一步提高周围血管离断术的疗效。

[Objective] To investigate the therapeutic effect of transabdominal gastroesophageal stapling in the management of variceal bleeding in portal hypertension. [Methods] From Aug 1998 to Aug 2004, 42 portal hy- pertension cases with variceal bleeding were treated with pericardial devascularization plus partial resection of lower part of esophagus with stapler. The operative mortality, recurrent bleeding rate and the eliminating rate or varicose vein and the anastomosis stenosis rate were evaluated. [Results] No rebleeding occurred during a 8 months to 3 years follow-up. One patient died, two developed postoperative anastomosis stenosis, no stomal fistula occurred. [Conclusion] The therapeutic effect of pericardial devascularization could be safely improved with transabdominal gastroesophageal stapling.