同期腹腔镜脾切除术和胆囊切除术。
Concomitant laparoscopic splenectomy and cholecystectomy.
作者信息
Sasaki Akira, Nitta Hiroyuki, Otuska Koki, Kimura Yusuke, Obuchi Toru, Wakabayashi Go
机构信息
Department of Surgery, Iwate Medical University School of Medicine, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2010 Apr;20(2):66-8. doi: 10.1097/SLE.0b013e3181d8493e.
PURPOSE
The aim of this study was to assess the feasibility and outcomes of concomitant laparoscopic treatment for coexisting spleen and gallbladder diseases.
METHODS
Between March 1997 and August 2009, 9 patients underwent concomitant laparoscopic splenectomy and cholecystectomy. Indications for laparoscopic splenectomy included hereditary spherocytosis (4 patients), splenic artery aneurysm (2), hypersplenism (2), and Evans syndrome (1).
RESULTS
The median operating time and the blood loss were 165 minutes (range: 70 to 300 min) and 36 mL (range: 10 to 274 mL). The median resected splenic weight was 256 g (range: 137 to 820 g). No patient required conversion to an open procedure. Portal system thrombosis occurred in 2 patients. The median length of hospital stay was 9 days (range: 3 to 15 d).
CONCLUSION
With increasing institutional experience, concomitant laparoscopic splenectomy and cholecystectomy is a safe and feasible procedure and may be considered for coexisting spleen and gallbladder diseases.
目的
本研究旨在评估同期腹腔镜治疗并存的脾脏和胆囊疾病的可行性及治疗效果。
方法
1997年3月至2009年8月期间，9例患者接受了同期腹腔镜脾切除术和胆囊切除术。腹腔镜脾切除术的适应证包括遗传性球形红细胞增多症（4例）、脾动脉瘤（2例）、脾功能亢进（2例）和伊文氏综合征（1例）。
结果
中位手术时间和失血量分别为165分钟（范围：70至300分钟）和36毫升（范围：10至274毫升）。切除脾脏的中位重量为256克（范围：137至820克）。无患者需要转为开放手术。2例患者发生门静脉系统血栓形成。中位住院时间为9天（范围：3至15天）。
结论
随着机构经验的增加，同期腹腔镜脾切除术和胆囊切除术是一种安全可行的手术，对于并存的脾脏和胆囊疾病可考虑采用。
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