摘要
目的探讨腹腔镜脾切除术治疗外伤性脾破裂的安全性与可行性。方法回顾性分析我院2006年10月至2009年10月期间经腹腔镜脾切除治疗的48例外伤性脾破裂患者,男32例,女16例。根据脾蒂的不同类型分别采取不同的处理方法,其中处理脾蒂采用钛夹夹闭12例,丝线结扎结合钛夹夹闭8例,圈套器结合钛夹夹闭处理10例,结扎束LigaSure处理8例,Endo-GIA处理8例。结果 32例顺利完成腹腔镜脾切除术,14例改行手助腹腔镜脾切除术,2例为脾周围粘连紧密伴胃短血管破裂出血而中转开腹。手术时间120~170 min,平均140 min;术中出血量300~1 200 ml,平均800 ml。术后无胃漏、胰漏、大出血等并发症发生。结论腹腔镜脾切除治疗外伤性脾破裂中,根据脾蒂的不同类型,采取个体化处理方案可减少术中出血及副损伤,提高手术成功率。
Objective To investigate the safety and feasibility of the treatment of laparoscopic splenectomy for patients with traumatic splenic rupture.Methods Between October 2006 and October 2009,48 cases of traumatic splenic rupture underwent laparoscopic splenectomy were analyzed in this hospital.According to the differrent styles of splenic stalk,different operative methods were taken,including titanic clipping in 12 cases,titanic clipping combining silk suture ligation in 8 cases,snare combining titanic clipping in 10 cases,LigaSure in 8 cases,and Endo-GIA in 8 cases.Results Laparoscopic splenectomy was successfully completed in 32 cases;Hand-assisted laparoscopic splenectomy was applied in 14 cases,and 2 cases were converted to laparotomy because of tight spleen adhesion with surrounding tissues and bleeding rupture of the short gastric vessels.The operation time was 120-170 min with an average 140 min;the estimated intraoperative amount of blood loss was 300-1 200 ml with an average 800 ml.No postoperative complication occurred such as gastric fistula,pancreatic fistula or hemorrhage.ConclusionAccording to the differrent styles of splenic stalk,individual operative method can improve mission success rate in the laparoscopic splenectomy in traumatic splenic rupture.
出处
《中国普外基础与临床杂志》
CAS
2011年第3期313-316,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
腹腔镜脾切除术
外伤性脾破裂
Laparoscopic splenectomy
Traumatic splenic rupture
