腹腔镜下胃腔探查治疗Dieulafoy病

Laparoscopic gastric cavity exploration to treat Dieulafoy lesions

目的探讨腹腔镜下胃腔探查,对胃镜治疗失败的Dieulafoy病出血点定位,以及腔镜下行止血治疗的临床效果。方法胃镜下治疗失败Dieulafoy病一例,术中胃壁以Troca造孔,胃腔内置入腔镜镜头及吸引器,冲洗胃腔清除积血,明确出血点,行缝扎止血治疗。结果术中胃腔探查顺利,止血效果满意,失血300 ml,手术时间2小时10分钟,术后予对症治疗,好转出院。结论腹腔镜下胃腔探查,可清晰暴露胃镜无法明确的出血点,行腹腔镜下止血治疗,操作简单,手术时间短、创伤小,术中失血少,可用于Dieulafoy病的治疗。

Objective To evaluate laparoscopic gastric cavity exploration of endoscopy treatment failure Dieulafoy lesions on bleeding source positioning as well as laparoscopic hemostasis clinical effects. Methods One case of Dieulafoy lesions treated failed under gastroscopy, during surgery make holes on gastric wall by troea, put the laparoscope into gastric cavity and flushing gastric cavity and remove accumulation of blood, make bleeding source clear, implement suture bleeding treatment. Results Explore gastric cavity successfully, with satisfactory hemostasis and blood loss being 300 ml, operative time was 130 min, symptomatic treatment after surgery, recovery and hospital discharged. Conclusions Laparoscopic gastric cavity exploration, can clearly exposed the bleeding source which endoscopic treatment is failed , laparoscopic hemostasis, simple, shorter operative time, less trauma, and less blood loss, can be used in the treatment of Dieulafoy lesions.