腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症的临床效果

Clinical effect of laparoscopic splenectomy combined with pericardial devascularization in the treatment of portal hypertension secondary to cirrhosis

目的研究腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症的临床效果。方法回顾性分析2015年1月至2019年6月因肝硬化门静脉高压症在我院完成腹腔镜脾切除加贲门周围血管离断术的50例患者的临床资料。结果50例患者中,手术成功实施48例,另有2例中转开腹。胃镜或上消化道造影提示除3例为食管胃底静脉轻度曲张外,其余均为中重度曲张。患者平均手术时间为(208.44±32.71)min,术中平均出血量为(266.83±25.37)mL。术后消化道功能恢复时间为(3.32±0.66)d,术后平均住院时间为(15.80±3.22)d。结论在严格掌握手术适应证并选择合适病例的情况下,腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症是安全可行的。

Objective To study the clinical effect of laparoscopic splenectomy combined with pericardial devascularization in the treatment of portal hypertension secondary to cirrhosis.Methods The clinical data of 50 cases received laparoscopic splenectomy combined with pericardial devascularization for portal hypertension secondary to cirrhosis in our hospital from January 2015 to June 2019 were analyzed retrospectively.Results Of the 50 patients,48 cases were operated successfully and 2 cases were converted to laparotomy.Gastroscopy or upper gastrointestinal radiography showed that except for 3 cases of mild esophageal and gastric varices,the others were moderate and severe varices.The average operation time was(208.44±32.71)min,and the average intraoperative bleeding volume was(266.83±25.37)mL.The recovery time of gastrointestinal function after operation was(3.32±0.66)days,and the average hospitalization time was(15.80±3.22)days.Conclusion Under strict control of surgical indications and selection of appropriate cases,laparoscopic splenectomy combined with pericardial devascularization is safe and feasible for the treatment of portal hypertension secondary to cirrhosis.