中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (07): 584-586.

• 论著 • 上一篇    下一篇

腹腔镜下脾切除67例体会

吴海福，盛卫忠，刘风林，顾大镛，姚礼庆，吴肇汉   

  1. 复旦大学附属中山医院普外科  复旦大学普通外科研究所，上海 200032
  • 出版日期:2010-07-01 发布日期:2010-06-17

  • Online:2010-07-01 Published:2010-06-17

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摘要：

目的    探讨腹腔镜下脾切除术的可行性和安全性。方法    回顾分析了2006年5月至2009年3月复旦大学附属中山医院普外科完成的67例腹腔镜下脾切除术临床资料，其中血液病26例，肝硬化、门静脉高压和脾亢25例，脾占位性病变16例。其中11例合并胆囊结石。 结果    67例病人平均脾脏切除时间2.2h，术中平均出血量83.9mL，术后平均住院时间6.4d。1例术后出血，8例术后引流液淀粉酶增高，其余病人无腹腔镜手术相关的术后并发症，无手术死亡。11例同时行腹腔镜胆囊切除术。13例巨脾病人行全腔镜下脾切除术。30例中转手助腹腔镜脾切除术，原因为：巨脾、肥胖、脾胰韧带极短、出血、粘连。1例门静脉高压病人中转开腹。结论    腹腔镜下脾切除术是安全可行的，适用于各种脾脏疾病。

关键词: 腹腔镜, 脾切除术

Abstract:

Experience of laparoscopic splenectomy: a report of 67 cases         WU Hai-fu, SHENG Wei-zhong，LIU Feng-lin, et al. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai200032, China
Corresponding：WU Hai-fu, E-mail: wu.haifu@zs-hospital.sh.cn
Abstract    Objective    To evaluate the safety and  feasibility of  laparoscopic splenectomy. Methods    It reviewed the perioperative outcomes of 67 patients who received  laparoscopic splenectomy from May 2006 to March 2009  at Zhongshan Hospital of Fudan University. Twenty-six patients with hemopathy inclnded 25 patients with cirrhosis, portal hypertension and hypersplenism, 16 patients with spleen tumour,   11 patients with gallstone concomitantly. Results    The average hours of spelenectomy were 2.2. The average amount of bleeding during operation is 83.9mL and the average days of postoperative discharging were 6.4. One patient was with postoperative bleeding, and 8 patients were with high  level of postoperative drainage liquid amylase. No complications or deaths directly resulted from LS happened in the rest patients. One patients with portal hypertension was converted to open surgery. Conclusion    Laparoscopic splenectomy is a new method of splenectomy with high safety and feasibility, which is suitable for various kinds of the spleen disease.

Key words: laparoscopy, splenectomy