脾蒂优先处理法在腹腔镜门静脉高压症巨脾切除术中的应用

Application of priority processing for splenic pedicle in laparoscopic splenectomy for portal hypertension and splenomegaly

回顾性分析42例接受腹腔镜手术治疗的门静脉高压症巨脾患者的临床资料。根据切脾方法不同，将患者分为脾蒂优先处理组，常规腹腔镜脾切除组。脾蒂优先处理组的手术时间、出血量显著低于常规腔镜脾切除组（均P〈0．05）。两组患者中转开腹率、术后下床时间、排气时间、住院时间、并发症发生率差异无统计学意义（均P〉0．05）。脾蒂优先处理在腹腔镜门静脉高压症巨脾切除中有明显的优势，可降低手术难度、缩短手术时间、减少出血。

A retrospective study was conducted based on the clinical data of 42 patients of portal hypertension and splenomegaly who underwent laparoscopic splenectomy. The pa- tients were divided into two groups including pedicle priority group and conventional group by different operative method. The operation time and intraoperative blood loss in the pedicle priori- ty group were significantly lower than those in the conventional group （ both P 〈 0.05 ）, and there was no statistically significant difference on the conversion rate of laparotomy, active time post- operation, exhaust time, postoperative hospitalization stay and the incidence of complications （ all P 〉 0.05）. Priority process- ing for splenic pedicle has obvious advantages in laparoscopic splenectomy for portal hypertension and splenomegaly, and it could reduce the difficulty of operation, shorten the operation time and reduce bleeding.