Cai Yun-Qiang, Li Chun-Lin, Zhang Hua, Wang Xin, Peng Bing
Yun-Qiang Cai, Chun-Lin Li, Hua Zhang, Xin Wang, Bing Peng, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2014 Dec 14;20(46):17670-3. doi: 10.3748/wjg.v20.i46.17670.
Splenic rupture is a common consequence of blunt abdominal trauma. Emergency splenectomy is indicated when conservative management is not effective. With better understanding of the immunologic function of the spleen, surgeons have begun to perform the splenic-preserving surgery. However, it is technical challenge to perform emergency laparoscopic partial splenectomy for patient with spleen rupture. A 15-year-old male patient suffered from grade III spleen injury basing on the American association for the surgery of trauma splenic injury scale. Conservative treatment failed to success basing on the dramatically decreased hemoglobin level. During the laparoscopic exploration, we found that two individual ruptures were associated with the upper pole of spleen. An emergency laparoscopic partial splenectomy was successfully carried out. The operative time was approximate 150 min and the estimated blood loss was 200 mL. The post-operative course was uneventful and the patient was discharged on the 7(th) post-operative day.
脾破裂是钝性腹部创伤的常见后果。当保守治疗无效时，需进行急诊脾切除术。随着对脾脏免疫功能的深入了解，外科医生已开始开展保脾手术。然而，对脾破裂患者进行急诊腹腔镜部分脾切除术是一项技术挑战。一名15岁男性患者，根据美国创伤外科协会脾损伤分级标准为Ⅲ级脾损伤。由于血红蛋白水平急剧下降，保守治疗失败。在腹腔镜探查中，我们发现脾上极有两处独立破裂。成功实施了急诊腹腔镜部分脾切除术。手术时间约150分钟，估计失血量为200毫升。术后过程顺利，患者于术后第7天出院。
