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中华肝脏外科手术学电子杂志 ›› 2016, Vol. 05 ›› Issue (05) : 308 -310. doi: 10.3877/cma.j.issn.2095-3232.2016.05.009

所属专题: 文献

临床研究

腹腔镜脾切除术在乙肝后肝硬化门静脉高压症脾肿大患者中的应用
顾炯1, 孙爱学1, 魏晓明1, 孙玉年1, 赵成功1,()   
  1. 1. 230031 合肥,中国人民解放军第105医院普通外科
  • 收稿日期:2016-05-25 出版日期:2016-10-10
  • 通信作者: 赵成功

Application of laparoscopic splenectomy in patients with HBV-related cirrhotic portal hypertension and splenomegaly

Jiong Gu1, Aixue Sun1, Xiaoming Wei1, Yunian Sun1, Chenggong Zhao1,()   

  1. 1. Department of General Surgery, 105th Hospital of Chinese People's Liberation Army, Hefei 230031, China
  • Received:2016-05-25 Published:2016-10-10
  • Corresponding author: Chenggong Zhao
  • About author:
    Corresponding author: Zhao Chenggong, Email:
引用本文:

顾炯, 孙爱学, 魏晓明, 孙玉年, 赵成功. 腹腔镜脾切除术在乙肝后肝硬化门静脉高压症脾肿大患者中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2016, 05(05): 308-310.

Jiong Gu, Aixue Sun, Xiaoming Wei, Yunian Sun, Chenggong Zhao. Application of laparoscopic splenectomy in patients with HBV-related cirrhotic portal hypertension and splenomegaly[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2016, 05(05): 308-310.

目的

探讨乙型病毒性肝炎(乙肝)后肝硬化门静脉高压症脾肿大患者腹腔镜脾切除术(LS)的安全性和疗效。

方法

回顾性分析2008年9月至2014年12月中国人民解放军第105医院行LS的10例乙肝后肝硬化门静脉高压症脾肿大患者临床资料。其中男4例,女6例;年龄28~65岁,中位年龄48岁。轻度脾肿大1例,中度脾肿大9例。患者均签署知情同意书,符合医学伦理学规定。所有患者均采用传统四孔法行LS,观察围手术期情况及并发症发生情况。

结果

10例患者均顺利完成LS,7例行单纯LS,2例行LS+胆囊切除术,1例行LS+门奇断流术。手术时间245(180~325)min,术中出血量200(20~800)ml,术中输血率5/10,并发症发生率8/10。1例术后死于弥散性血管内凝血,其余均康复出院。

结论

LS治疗乙肝后肝硬化门静脉高压症脾肿大患者安全、有效。

Objective

To investigate the safety and efficacy of laparoscopic splenectomy (LS) in patients with hepatitis B virus (HBV)-related cirrhotic, portal hypertension and splenomegaly.

Methods

Clinical data of 10 patients with HBV-related cirrhotic, portal hypertension and splenomegaly undergoing LS in 105th Hospital of Chinese People's Liberation Army between September 2008 and December 2014 were retrospectively analyzed. Among the patients, 4 were males and 6 were females, with the age ranging from 28 to 65 years old and the median of 48 years old. One case was with mild splenomegaly and 9 were with moderate splenomegaly. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients received conventional LS by 4-port approach. The perioperative conditions and complications were observed.

Results

LS was successfully performed on all the patients. Seven cases underwent simple LS, 2 underwent LS + cholecystectomy, and 1 underwent LS + portal-azygous disconnection. The operation duration was 245 (180-325) min, the intraoperative blood loss was 200 (20-800) ml, the intraoperation blood transfusion rate was 5/10 and the incidence of complications was 8/10. One case died of disseminated intravascular coagulation, and other patients discharged after recovery.

Conclusion

LS is safe and effective for patients with HBV-related cirrhotic, portal hypertension and splenomegaly.

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