脾切除术联合门奇静脉断流术治疗肝硬化门脉高压症患者疗效研究*

doi:10.3969/j.issn.1672-5069.2020.02.025

Abstract

Abstract: Objective The aim of this study was to investigate the efficacy of laparoscopic portal-azygos vein devascularization and splenectomy in treatment of patients withcirrhotic portal hypertension. Methods 86 patients with cirrhotic portal hypertension complicated with megaspleen were enrolled in our hospital between December 2016 and December 2018, and 43 patients underwent open and other 43 underwentlaparoscopic portal-azygos vein devascularization and splenectomy. Results The bleeding volume and hospital stay in patients with laparoscopic surgery were(180.8±23.1)ml and (6.0±1.3)d, significantly less or shorter than 【(286.4±35.7)ml and (8.6±1.5)d,P<0.05】 in patients with open surgery; seven days after operation, the white blood cell andplatelet counts in patients with laparoscopic surgery were (8.9±1.4)×10⁹/L and (132.0±28.9)×10⁹/L, and those in patients with open operation were (7.2±1.8)×10⁹/L and (125.6±30.3)×10⁹/L, respectively, all significantly increased as compared to these before operation (P<0.05); the portal vain diameters and blood volume in patients with laparoscopic operationwere(1.2±0.1)cm and (911.7±261.7)ml/min, and those in patients with opensurgery were (1.2±0.2)cm and (888.5±191.5)ml/min, respectively, all significantly narrowed or decreased as compared to these beforeoperation (P<0.05); the post-operational complications in patients with laparoscopic surgery was 9.3%, much lower than 37.2%(P＜0.05) in patients with open operation. Conclusion The application of laparoscopic portal-azygos vein devascularization and splenectomy is efficacious in the treatment of patients with cirrhotic portal hypertension and megaspleen. It might have less trauma, low incidence of complications and quick recovery.

Key words: Liver cirrhosis, Portal hypertension, Laparoscopic portal-azygos vein devascularization, Splenectomy, Laparoscopy

A Sigen, Xia Yijun, Wu Huijun, et al. Efficacy of laparoscopic portal-azygos vein devascularization and splenectomy in treatment of patients with cirrhotic portal hypertension[J]. Journal of Practical Hepatology, 2020, 23(2): 248-251.

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Efficacy of laparoscopic portal-azygos vein devascularization and splenectomy in treatment of patients with cirrhotic portal hypertension

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