手助腹腔镜脾切除联合贲门周围血管离断术在门静脉高压症中的临床应用：附14例报告

Clinical value of hand-assisted laparoscopic splenectomy in combination with pericardial devascularization for portal hypertension

目的探讨手助腹腔镜脾切除联合贲门周围血管离断术在门静脉高压症中的临床应用价值。方法2005年1月至2006年2月共进行14例手助腹腔镜脾切除联合贲门周围血管离断术。结果14例在手助腹腔镜下进行，无中转开腹病例。手术时间2～3．5h，平均2．6h。术中失血量120±350ml，平均（220±63）ml。无膈下感染、近期再出血和肝功衰竭发生。结论手助腹腔镜脾切除联合贲门周围血管离断术安全、操作方便，止血确切，可有效降低手术对机体的打击和肝功能损害，具有一定的临床应用价值。

Objective To investigate the value of hand-assisted laparoscopic splenectomy （HALS） in combination with pericardial devascularization for portal hypertension. Methods From January 2005 to February 2006, HALS splenectomy in combination with pericardial devascularization was performed in 14 cases. Results HALS was accomplished successfully in 14 cases and none of them received laparotomy. The operative duration was 2 to 3. 5 h （mean=2. 6 h）. The volume of blood loss was 120 to 350 ml and averaged （202±63）ml. No subphrenic infections and recurrent variceal bleeding in a short period of time and hepatic failure occurred. Conclusions HALS in combination with pericardial devascularization is a safe and feasible surgical procedure and it has merits on stopping hemorrhage, decreasing the injury to the body and lessen the damage to the liver function. HALS in combination with pericardial devascularization is a rational and practical procedure for clinical application.