内镜指导下选择性贲门周围血管离断术的临床应用价值

The experience of selective pericardia devascularization under the guidance of endoscopic for the patients with portal hypertension

目的 探讨术中胃镜在选择性贲门周围血管离断术中的应用价值.方法 16例门静脉高压症伴食管静脉曲张病人行术中胃镜指导下选择性贲门周围血管离断术,观察术后效果.结果 16例病人手术均较顺利,术后1例24 h内出现腹腔出血,经再次手术,病人恢复良好.术后病人无再出血表现.术后随访4～26个月,无一例再出现黑便及呕血,无吞咽梗阻症状发生,术后3个月胃镜检查见食管静脉曲张较术前食管静脉曲张明显好转.结论 术中胃镜能准确地提供手术视野,准确地判断食管胃底静脉曲张的位置,可指导选择性贲门周围血管离断术.

Objective To evaluate the curative effect of the selective pericordia devascularization under the guidance of endoscopic for the patients with portal hypertension. Methods Sixteen cases of portal hypertension were treated by selective pericardial devascularization and were observed the effect of postoperative. Results Intraoperative endoscopy can guide the selective pericardia devasculariza- tion, The position of esophageal varices can be accurately determined by intraop-erative endoscopic, The rebleeding after operation cases was not found. Conclusions Intraot^e-rative endoscopy can accu- rately pro,zide surgical field and determine the location of the esoph-ageal gastric varices, Selective pericardia devascularization can be guided by endoscopy.