手助腹腔镜门脉高压症的脾切除和门奇静脉断流术(英文)

Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure for patients with portal hypertension

目的探讨手助腹腔镜脾切除门奇断流术的手术技术.方法用手助腹腔镜完成18例脾切除门奇断流术.结果18例手术全部成功.手术时间150～260 min,平均180min.术中出血200～2000 mL,平均540mL.切除脾重500～2000 g,平均910 g.住院时间8～18 d,平均9.7 d.术后病人恢复顺利,疼痛少,5例术后用止痛剂,24～74h排气,平均52h.手助切口愈合良好,1例出现并发症,1例术后因肝功能衰竭死亡.结论手助腹腔镜行脾切除门奇断流术不但安全可行,而且具有微创手术的优点,疗效满意.

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results ] The operations were completed successfully. The mean operative time was 180（150-260） minutes, the mean blood loss estimated was 540（200-2 000） mL, the mean weight of spleen was 910 （500-2000） g and the mean length of hospital stay was 9.7 （8-18） days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52（24-74） hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.