中国实用外科杂志

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腹腔镜左半结肠手术中脾脏、胰腺损伤及处理

张    卫   

  1. 海军军医大学第一附属医院肛肠外科,上海200433
  • 出版日期:2022-11-01

  • Online:2022-11-01

摘要: 腹腔镜左半结肠手术中脾脏及胰腺损伤相对少见。由于特殊的解剖部位及胚胎发育因素,在游离脾曲的过程中,牵拉过度及对解剖的认识不足是造成脾脏或胰腺的意外损伤的主要原因,处理不当会带来比较严重的近期和远期后果,必须引起外科医生的高度重视。熟悉解剖、提升技术、谨慎操作、平面准确、良好的视野可以减少脾脏及胰腺意外损伤。另外,选择腹腔镜手术而非开放手术可能是减少意外脾及胰腺损伤的一条重要途径。

关键词: 腹腔镜, 左半结肠切除术, 脾损伤, 胰腺损伤

Abstract: Splenic and pancreatic injury and management during laparoscopic left hemicolonic surgery        ZHANG Wei. Department of Colorectal Surgery, the First Affiliated Hospital,Navy Medical University,Shanghai 200043, China
Abstract    The accidental injury of the spleen or pancreas during laparoscopic left hemicolectomy is relatively rare. Due to the special anatomical site and embryonic development factors, the main causes for the accidental injury of the spleen or pancreas during the process of free splenic flexion are overstretch and the lack of understanding of anatomy. Improper treatment will bring serious short-term and long-term complications, which must be paid attention to by surgeons. Familiarity with anatomy, improved technology, cautious operation, clean-cut surgery field, and good vision can reduce spleen and pancreas accidental injury. In addition, choosing laparoscopic surgery, instead of open surgery may be an important way to reduce accidental splenic and pancreatic injury.

Key words: laparoscopy, left hemicolectomy, splenic injury, pancreatic injury