A simple technique of tunnel constructing behind the tail of pancreas for occluding splenic vesselsincomplex splenectomy

doi:10.3969/j.issn.1003-5591.2019.02.002

PDF(867 KB)

Journal of Abdominal Surgery ›› 2019, Vol. 32 ›› Issue (2) : 80-83. DOI: 10.3969/j.issn.1003-5591.2019.02.002

A simple technique of tunnel constructing behind the tail of pancreas for occluding splenic vesselsincomplex splenectomy

Tang Yong, Li Min, Cao Guojun, Hu Qinggang, Wan Chidan

Author information +

History +

Abstract

Objective To investigate the role and efficacy of splenic pedicle blood flow preparative blocade by tunneling posterior to the tail of pancreas in complex laparoscopic splenectomy.Methods The clinical data of 61 patients with complex splenectomy from June 2016 to May 2017 were retrospectively analyzed. During the operation, retropancreatic tunnel was established to preparatively block the splenic pedicle arteriovenous blood flow, and then the splenic pedicle was severed. The operation time, intraoperative blood loss, conversion rate to laparotomy, incidence of complications and postoperative hospital stay were analyzed in this group of patients to evaluate the feasibility and clinical effect of the establishment of retropancreatic tunnel.Results All 61 operations were successfully completed. There was no conversion to laparotomy and no patients need blood transfusion during the operation. The mean operative time was (81.8±14.5) min,mean intraoperative blood loss was (68.6±23.2) ml,mean postoperative hospital stays was (7.1±2.0) days. Conclusion Laparoscopic splenectomy can be performed safely and successfully by pre-blocking the blood flow of splenic artery and vein through retropancreatic tunnel, which is a simple and feasible surgical method.

Key words

Laparoscopy / Splenectomy / Tunnel / Goldfinger dissector

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

Tang Yong, Li Min, Cao Guojun, Hu Qinggang, Wan Chidan. A simple technique of tunnel constructing behind the tail of pancreas for occluding splenic vesselsincomplex splenectomy[J]. Journal of Abdominal Surgery, 2019, 32(2): 80-83 https://doi.org/10.3969/j.issn.1003-5591.2019.02.002

References

[1] Habermalz B,Sauerland S,Decker G,et al.Laparoscopic splenectomy:the clinical practice guidelines of the European Association for endoscopic surgery (EAES)[J].Surg Endosc,2008,22(4):821-848.DOI:10.1007/s00464-007-9735-5.
[2] Cai Y,Liu Z,Liu X.Laparoscopic versus open splenectomy for portal hypertension:a systematic review of comparative studies[J].Surg Innov,2014,21(4):442-447.DOI:10.1177/1553350613520513.
[3] Al-raimi K,Zheng SS.Postoperative outcomes after open splenectomy versus laparoscopic splenectomy in cirrhotic patients:a meta-analysis[J].Hepatobiliary Pancreat Dis Int,2016,15(1):14-20.DOI:10.1016/S1499-3872(16)60053-X.
[4] Wu Z,Zhou J,Pankaj P,et al.Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy[J].Surg Endos,2012,26(10):2758-2766.DOI:10.1007/s00464-012-2270-z.
[5] Ohta M,Nishizaki T,Matsumoto T,et al.Analysis of risk factors for massive intraoperative bleeding during laparoscopic splenectomy[J].J Hepatobiliary Pancreatic Surg,2005,12(6):433-437.DOI:10.1007/s00534-005-1027-7.
[6] 唐勇,王文静,张宇,等.腹腔镜脾切除加贲门周围血管离断术治疗门静脉高压症的疗效评价[J].中华普通外科杂志,2016,31(2):93-96.DOI:10.3760/cma.j.issn.1007-631X.2016.02.002.
[7] Yao L,Long Z,Yong T,et al.Laparoscopic versus Open Splenectomy and Devascularization for Massive Splenomegaly Due to Portal Hypertension[J].J Huazhong Univ Sci Technolog Med Sci,2016,36(6):876-880.DOI:10.1007/s11596-016-1678-4.
[8] Wang WJ,Tang Y,Zhang Y,et al.Prevention and treatment of hemorrhage during laparoscopic splenectomy and devascularization for portal hypertension[J].J Huazhong Univ Sci Technolog Med Sci,2015,35(1):99-104.DOI:10.1007/s11596-015-1396-3.
[9] 施申超,唐勇,张宇,等."胃蒂"组织一步离断法在腹腔镜贲门周围血管离断术中的应用[J].腹部外科,2015,28(3):189-192.DOI:10.3969/j.issn.1003-5591.2015.03.014.
[10] Zhan XL,Ji Y,Wang YD.Laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension[J].World J Gastroenterol,2014,20(19):5794-5800.DOI:10.3748/wjg.v20.i19.5794.
[11] Zhou J,Wu Z,Wu J,et al.Laparoscopic splenectomy plus preoperative endoscopic variceal ligation versus splenectomy with pericardial devascularization (Hassab's operation) for control of severe varices due to portal hypertension[J].Surg Endosc,2013,27(11):4371-4377.DOI:10.1007/s00464-013-3057-6.
[12] Bai DS,Qian JJ,Chen P,et al.Laparoscopic azygoportal disconnection with and without splenectomy for portal hypertension[J].Int J Surg,2016,34:116-121.DOI:10.1016/j.ijsu.2016.08.519.
[13] Yamamoto N,Okano K,Oshima M,et al.Laparoscopic splenectomy for patients with liver cirrhosis:improvement ofliver function in patients with Child-Pugh class B[J].Surgery,2015,158(6):1538-1544.DOI:10.1016/j.surg.2015.05.008.
[14] Wang X,Li Y,Crook N,et al.Laparoscopic splenectomy:a surgeon's experience of 302 patients with analysis of postoperative complications[J].Surg Endosc,2013,27(10):3564-3571.DOI:10.1007/s00464-013-2978-4.
[15] Yu H,Guo S,Wang L,et al.Laparoscopic splenectomy and esophagogastric devascularization for liver cirrhosis and portal hypertension is a safe,effective,and minimally invasive operation[J].J Laparoendosco Adv Surg Tech A,2016,26(7):524-530.DOI:10.1089/lap.2016.0032.
[16] Vecchio R,Marchese S,Swehli E,et al.Splenic hilum management during laparoscopic splenectomy[J].J Laparoendosco Adv Surg Tech A,2011,21(8):717-720.DOI:10.1089/lap.2011.0165.
[17] Radkowiak D,Zychowicz A,Lasek A,et al.20 years' experience with laparoscopic splenectomy.Single center outcomes of a cohort study of 500 cases[J].Int J Surg,2018,52:285-292.DOI:10.1016/j.ijsu.2018.02.042.
[18] Pringle JH.Notes on the arrest of hepatic hemorrhage due to trauma[J].Ann Surg,1908,48(4):541-549.
[19] Cheng Z,Yu F,Tian J,et al.A comparative study of two anti-coagulation plans on the prevention of PVST after laparoscopic splenectomy and esophagogastric devascularization[J].J Thromb Thrombolysis,2015,40(3):294-301.DOI:10.1007/s11239-015-1190-x.
[20] Zhang X,Wang Y,Yu M,et al.Effective Prevention for Portal Venous System Thrombosis After Splenectomy:A Meta-Analysis[J].J Laparoendosc Adv Surg Tech A,2017,27(3):247-252.DOI:10.1089/lap.2016.0511.

PDF(867 KB)

616

Accesses

Citation

Detail

Sections

Recommended

Abstract
Key words
Cite this article
References

Received	Published
2019-03-05	2019-04-22
Issue Date
2019-04-26

Please choose a citation manager

Content to export

Abstract

Key words

Cite this article

{{custom_sec.title}}

{{custom_sec.title}}

References

{{custom_fnGroup.title_en}}

Footnotes

模态框（Modal）标题

Please choose a citation manager

Content to export

Abstract

Key words

Cite this article

{{custom_sec.title}}

{{custom_sec.title}}

References

{{custom_fnGroup.title_en}}

Footnotes