Clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension complicated with splenic aneurysm
10.3760/cma.j.cn115610-20220928-00557
- VernacularTitle:完全腹腔镜脾动脉瘤隔绝联合贲门周围血管离断术治疗门静脉高压症合并脾动脉瘤的临床价值
- Author:
Zhiwu ZENG
1
;
Hui XIA
;
Cini DENG
;
Li LIU
;
Guangyao YANG
;
Dong CHEN
;
Cheng ZHOU
;
Zhao GONG
;
Weiyu WANG
Author Information
1. 深圳大学总医院普通外科，深圳 518071
- Keywords:
Vein hypertension;
Splenic artery aneurysm;
Splenic artery aneurysm exclu-sion;
Pericardial devascularization;
Laparoscopy
- From:
Chinese Journal of Digestive Surgery
2022;21(12):1586-1592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension com-plicated with splenic aneurysm.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with portal hypertension complicated with splenic aneurysm who were admitted to 2 medical centers (15 cases in Shenzhen University General Hospital and 2 cases in Wuhan First Hospital) from January 2013 to May 2020 were collected. There were 7 males and 10 females, aged (59±14)years. All patients underwent totally laparoscopic exoclusion of splenic artery aneurysm combined with pericardial devascularization. Observation indicators : (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by out-patient examiantion and telephone interview to detect the effect of exclusion of arterial tumor, and blood re-flow, portal vein thrombosis and survival of patients 3 months after operation. The follow-up was up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Results:(1) Surgical and postoperative conditions. All 17 patients successfully completed the operation, without perioperative death. The operation time, volume of intraoperative blood loss of 17 patients were (181±30)minutes, 187(range, 90?420)mL. The white blood cell count, red blood cell count, hemoglobin, serum albumin were (9±4)×10 9/L, (3.5±0.9)×10 12/L, (86±17)g/L, (36±7)g/L on the postoperative day 3. Time to postoperative abdominal drainage tube removal and duration of post-operative hospital stay were (7±4)days and (11±4)days. (2) Complications. All 17 patients had ascites after surgery, which were improved after oral treatment with diuretics. There was no complication such as intra-abdominal hemorrhage, gastrointestinal fistula, pleural effusion, infection, abscess formation, fever and vascular embolism. (3) Follow-up. All the 17 patients were followed up for 28.6(range, 7.0?84.0)months. During the follow-up, the splenic aneurysm cavity of all patients was completely isolated, no blood re-flow and no portal vein thrombosis was observed, and no patient died. Conclusion:Totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization is safe and feasible in the treatment of portal hypertension complicated with splenic aneurysm.
