Discussion on the intraoperative bleeding control strategies in total laparoscopic complex splenectomy
10.3760/cma.j.cn113884-20230701-00192
- VernacularTitle:完全腹腔镜下复杂性脾切除术中出血控制策略探讨
- Author:
Yongqiang GUO
1
;
Ruopeng LIANG
;
Yun HE
;
Renyin CHEN
;
Yufeng ZHANG
Author Information
1. 郑州大学第一附属医院肝胆胰外科，郑州 450052
- Keywords:
Laparoscopes;
Complex splenectomy;
Intraoperative bleeding;
Strategies
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(9):683-686
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the control strategies of intraoperative bleeding in total laparoscopic complex splenectomy.Methods:The clinical data of 11 patients who underwent total laparoscopic complex splenectomy from May 2016 to October 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, including 3 males and 8 females, aged (43.5±16.3) years. Splenectomy was performed in 8 cirrhotic patients with portal hypertension and 3 patients with hematologic diseases. Intraoperative bleeding was controlled by priority splenic artery blocking, bleeding prevention strategies of perisplenic and splenic pedicle dissociation. The operative time, intraoperative blood loss, postoperative exhaust time, postoperative drainage tube removal time and postoperative complications were analyzed.Results:All 11 patients underwent total laparoscopic complex splenectomy successfully. The operative time of 11 patients was (242.8±43.6) min, and the intraoperative blood loss was 180(50-1 480) ml. The postoperative exhaust time was (3.9±0.8) d, the removal time of abdominal drainage tube was (6.4±0.8) d, and the postoperative hospitalization time was (13.1±3.9) d. The 11 patients had no postoperative complications such as hemorrhage, pancreatic fistula, gastric fistula, colon injury, infection, etc. One patient had splenic vein thrombosis, 2 patients had mild pancreatitis, and 4 patients had moderate ascites.Conclusion:Intraoperative bleeding could be controlled by priority splenic artery blocking, bleeding prevention strategies of perisplenic and splenic pedicle dissociation, which is one of the important guarantees for the success of total laparoscopic complicated splenectomy.
