腹腔镜选择性贲门周围血管离断术

Clinical analysis of the selective laparoscopic pericardial devascularization for cirrhotic patients with portal hypertension

国内外对腹腔镜贲门周围血管离断术均有报道,但由于巨脾、丰富的侧枝循环增加了手术难度和风险,如何安全、精准、有效、微创地完成断流术仍然是具有极大挑战性。腹腔镜选择性贲门周围血管离断术包括巨脾切除,离断高位食管支和异位高位食管支,分离食管下段6~8 cm,离断胃短静脉、胃后静脉、左膈下静脉。该术式对于脾长径≤20 cm的门脉高压症患者是安全可行、微创有效的,有望成为标准术式。

There were some domestic and foreign reports in relation to pericardial devascularization for the portal hypertension. However, splenomegaly and abundant collateral circulation increase the difficulty and risk of operation and give rise to a great challenge for how to safely, precisely, effectively and minimally invasive devascularization. Selective laparoscopic pericardial devascnlarization includes Yellowing steps： laparoscopic splenectomy for massive splenomegaly, devascularization of high esophageal branch and ectopic high esophageal branch within 6-8cm of lower esophagus, devascularization of short gastric vein, posterior gastric vein, left inferior phrenic vein. It showed that selective laparoscopic pericardial devascularization is a feasible, safe, effective and minimally invasive operation for the selective cases with spleen length less than 20 centimeters,would likely to become a standard operation.