分束脾蒂离断术在巨脾切除术中的应用

VALUE OF TECHNIQUE OF SEPARATE SPLEEN PEDICLE SEVERANCE FOR MEGALO-SPLENECTOMY

目的探讨分束脾蒂离断术在巨脾切除术中的应用价值。方法自2002年1月～2008年4月,将我院85例巨脾病人随机分成传统脾蒂离断组(n=40)和分束脾蒂离断组(n=45),就脾蒂继发出血、胰瘘、脾热、手术时间和出血量进行对比分析。结果分束脾蒂离断组术后无脾蒂继发出血;胰瘘的发生率明显低于传统脾蒂离断组(P<0.05);手术时间和出血量无显著差异(P>0.05)。结论分束脾蒂离断术可减少巨脾切除术后脾蒂继发出血,预防胰瘘的发生。

Objective To evaluate the value of technique of separate spleen pedicle severance for megalo-splenectomy. Methods From January of 2002 to April of 2008, 85 cases with megalosplenia were random divided into traditional spleen pedicle severance group （n = 40） and separate spleen pedicle severance group （n = 45 ） , and complications of secondary spleen pedicle hemorrhage, pancreatic fistula and spleen fever were compared between two groups. Operation time and blood loss volume were also observed during the period of splenectomy. Results No secondary spleen pedicle hemorrhage occurred in separate spleen pedicle severance group. The incidence rate of pancreatic fistula in separate spleen pedicle severance group is lower than that in traditional spleen pedicle severance group （ P 〈 0. 05 ）. The operation time and blood loss volume are no significantly different in two groups （P 〉 0. 05）. Conclusion The technique of separate spleen pedicle severance for megalo-splenectomy can reduce complication of secondary spleen pedicle hemorrhage, and can prevent pancreatic fistula.