Kehila M, Abderrahim T
Service de Chirurgie, CHU F. Hached, Sousse, Tunisie.
Ann Chir. 1993;47(5):433-5.
Conservative treatment of the spleen is generally based on segmental terminal vascularization of the spleen. The practise of partial splenectomies in the case of major trauma and hilar hydatid cyst led us to perform subtotal splenectomies after splenic vessel ligation. The upper pole splenic remnant after reduction of its volume, remains vascularized by other short vessels through the gastro-splenic ligament. The lower pole splenic remnant remains vascularized by the left gastro-epiploic artery. The follow-up of 40 subtotal splenectomies performed in these conditions revealed better results than those obtained after spleen autotransplantation in the omentum. Conservation of all the vessels of the gastro-epiploic ligament allows gastric transposition of the spleen.
脾脏的保守治疗通常基于脾脏的节段性终末血管化。在严重创伤和肝门部包虫囊肿病例中进行部分脾切除术的实践,促使我们在结扎脾血管后进行次全脾切除术。上极脾残余在体积缩小后,仍通过胃脾韧带中的其他短血管获得血供。下极脾残余则由胃网膜左动脉供血。在这些情况下进行的40例次全脾切除术的随访结果显示,其效果优于脾自体移植至大网膜后的效果。保留胃网膜韧带的所有血管可实现脾脏的胃移位。