Vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection
10.3760/cma.j.issn.1007-631X.2018.07.005
- VernacularTitle:保留迷走神经的腹腔镜脾切除联合断流术治疗门静脉高压症的疗效评价
- Author:
Guoqing JIANG
1
;
Dousheng BAI
;
Ping CHEN
;
Jianjun QIAN
;
Jie YAO
;
Shengjie JIN
;
Xiaodong WANG
;
Zhihui GAO
Author Information
1. 扬州大学临床医学院肝胆外科
- Keywords:
Hypertension,portal;
Vagus nerve;
Laparoscopy;
Azygoportal disconnection
- From:
Chinese Journal of General Surgery
2018;33(7):548-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical safety and value of vagus nerve-preserving versus conventional laparoscopic splenectomy and azygoportal disconnection.Methods A total of 60 cirrhotic patients with bleeding portal hypertension undergoing modified laparoscopic splenectomy and azygoportal disconnection between Apr 2015 and Sep 2016 were retrospectively analyzed.Patients were divided into nonvagus nerve-preserving (n =37) and vagus nerve-preserving group (n =23).Results Operative time (169 ± 42) min,and incidences of postoperative complications (102/370),delayed gastric emptying (35/37),epigastric fullness (22/37),diarrhea (26/37) in non-vagus nerve-preserving group were all more than those in vagus nerve-preserving group [(147 ± 21) min,(21/230),(2/23),(2/23),(2/23)] (t =2.684,x2 =29.583,44.272,15.229,21.606,all P ＜ 0.05).There was no significant between-group difference in body weight at admission and on postoperative day 7 (POD 7) between the two groups.However,body weight in vagus nerve-preserving group was significantly higher on postoperative 6 month (POM) compared with that in non-vagus nerve-preserving group [(63 ± 10) kg vs.(70 ± 12) kg,t =2.546,P ＜ 0.05].There was no significant between-group difference in ALB levels at admission and on POD 7 between the two groups.However,ALB levels in vagus nerve-preserving group at POM 6 were significantly higher than those in non-vagus nerve-preserving group [(42 ±6) g/L vs.(46 ±5) g/L,t =-2.607,P ＜ 0.05].Conclusion Vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection for cirrhotic portal hypertension is safe,feasible and with good therapeutic effect.
