腹腔镜选择性贲门周围血管离断术的方法和技巧

Methods and skills of selective laparoscopic pericardial devascularization

完全腹腔镜下贲门周围血管离断术治疗门静脉高压症的手术逐年增多,其适应症和禁忌症已基本与传统开腹的贲门周围血管离断术相同,且具有创伤小、恢复快、住院时间短等优点。但由于术后门静脉系统持续高压、食管胃底侧支循环和静脉曲张的再建立,术后出血的再发生率明显增高。随着腹腔镜技术的发展,选择性的贲门周围血管离断术可能成为一种治疗门静脉高压症的理想术式。本文着重介绍腹腔镜选择性贲门周围血管离断术的方法和技巧。

Total laparoscopic pericardial devascularization for treatment of portal hypertension, with some advantages such as minimally invasion and faster recovery and shorter hospital stay, has been more and more performed in recent years. Its indications and contraindications are similar to that of open surgery. However, postoperative recurrent bleeding rate raised obviously due to persistence high pressure of portal system and restitutions of esophagogastric collateral circulation and varicose vein. With developments of laparoscopic technique, selective laparoscopic peridicardial devascularization is looking forward to be a ideal procedure for treatment of portal hypertension. This paper emphasizes on introducing methods and skills of selective laparoscopic peridicardial devascularization.