Laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhosis-induced portal hypertension
10.3877/cma.j.issn.2095-3232.2015.03.005
- VernacularTitle:腹腔镜脾切除+贲门周围血管离断术治疗肝硬化门静脉高压症
- Author:
Xinhua ZHONG
1
;
Yuan LIU
;
Bo LIU
;
Kunpeng HU
Author Information
1. 中山大学附属第三医院岭南医院门诊办公室
- Keywords:
Hypertension,porta;
Splenomegaly;
Splenectomy;
Laparoscopes
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2015;(3):154-156
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the safety and application value of laparoscopic splenectomy combined with pericardial devascularization (devascularization) in the treatment of cirrhosis-induced portal hypertension.MethodsClinical data of 32 patients with cirrhosis and portal hypertension undergoing laparoscopic devascularization in Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from November 2011 to November 2013 were retrospectively studied. Among the 32 patients, 26 were males and 6 were females with the age ranging from 40 to 69 years old and the median of 53 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients received laparoscopic devascularization under intratracheal intubation anesthesia combined with intravenous anesthesia. One week before surgery, the patients were instructed to quit smoking and drinking, and received respiratory function training and in-bed toilet training. Vital signs were closely monitored and drainage volume was observed after surgery.ResultsAll patients received larparoscopic devascularization successfully, with the average operation time of (110±15) min, intraoperative blood loss of (200±52) ml and length of hospital stay of (7±2) d. The blood coagulation and color Doppler ultrasound of portal vein were regularly followed up within 3 months after surgery. Seven cases suffered portal vein thrombosis after surgery and recovered after adjusting the anti-platelet and anti-coagulation therapy according to the situation of platelets and thrombus. No death, massive hemorrhage, digestive tract ifstula and infection occurred during perioperative period.ConclusionsLaparoscopic devascularization in the treatment of cirrhosis-induced portal hypertension is safe and effective. The rigorous perioperative management guarantees the safety of surgery.
