Cadiere G B, Verroken R, Himpens J, Bruyns J, Efira M, De Wit S
Department of Gastrointestinal Surgery, Saint-Pierre Hospital, Free University of Brussels, Belgium.
J Am Coll Surg. 1994 Dec;179(6):668-72.
Laparoscopic splenectomy was attempted in 17 consecutive patients and was successful in 15.
This study is a critical analysis of the operative strategy in laparoscopic splenectomy, as reviewed in the operative video recordings and operative summaries of the 17 patients discussed.
The 15 successful laparoscopic splenectomies were all conducted according to the same strategy: mobilization of both the upper and lower pole of the spleen, division of the short gastric vessels close to the spleen, and dissection and separate ligation of the main trunk of the splenic artery and vein. An erroneous strategy that diverged from the one proposed, resulted in parenchymatous hemorrhage and open conversion in two patients.
In this series of 15 successful laparoscopic splenectomies, the most important technical aspect seems to be full mobilization of the spleen before the hilum is dissected.
对连续17例患者尝试进行腹腔镜脾切除术，其中15例成功。
本研究是对腹腔镜脾切除术手术策略的批判性分析，回顾了所讨论的17例患者的手术视频记录和手术总结。
15例成功的腹腔镜脾切除术均按照相同策略进行：游离脾脏上下极，在靠近脾脏处离断胃短血管，解剖并分别结扎脾动脉和脾静脉主干。有2例患者采用了与建议策略不同的错误策略，导致实质内出血并中转开腹。
在这一系列15例成功的腹腔镜脾切除术中，最重要的技术方面似乎是在解剖脾门之前充分游离脾脏。
