腹腔镜改良Sugiura手术治疗门静脉高压症的疗效分析

Laparoscopic modified Sugiura procedure for portal hypertension

目的探讨腹腔镜改良Sugiura手术（联合断流术）的手术方法、安全性和有效性。方法从2005年5月至2006年5月对5例肝硬化门静脉高压症、继发性脾功能亢进和上消化道出血患者进行了腹腔镜改良Sugiura手术,即脾切除、门奇静脉断流、食管下段管形吻合器横断和吻合术。结果5例腹腔镜改良Sugiura手术全部完成,无1例需中转开腹手术。手术时间3.5～5.0h,出血量100～400ml。术后住院10～15d。结论腹腔镜改良Sugiura手术在技术上是切实可行的,具有疗效确定、对机体影响小、并发症少和恢复快等优点。

Objective To explore the safety and efficacy of laparoscopic modified Sugiura procedure for the treatment of portal hypertension and secondary hypersplenism. Methods Laparoscopic splenectomy and extensive esophagogastric devascularization with esophageal stapling （modified Sugiura procedure） were performed in 5 patients with cirrhosis, bleeding portal hypertension and secondary hypersplenism between May 2005 and May 2006. Results Laparoscopic modified Sugiura procedure was completed successfully in all patients, with no intraoperative conversion to open surgery. The operation time ranged from 3.5 - 5. 0 hours and the blood loss was 100 -400 ml. The postoperative hospital stay was 10 - 15 days. Conclusion Laparoscopic modified Sugiura procedure is a feasible, effective and safe surgical procedure, and has all the benefits of minimally invasive surgery for cirrhotic patients with a history of variceal bleeding and hypersplenism. Laparoscopic modified Sugiura procedure offers a new alternative for the treatment of portal hypertension.