Effect of Partial Splenic Embolization on Splenectomy plus Devascularization of Esopha-geal and Gastric Vein_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 DENGChi-duo , QINHuai-cheng , ZHONGXian-rong , LIANGSan-hai

Department of General Surgery, Guidong People's Hospital of Guangxi Zhuang Autonomous Region, Wuzhou 543000, Guangxi Zhuang Autonomous Region, China;

Corresponding?author：

DENGChi-duo, Email: 312883849@qq.com

Keywords：

Partial splenic embolization; Portal hypertension; Hypersplenism; Splenectomy; Devascularization of esophageal and gastric vein

DOI：

10.7507/1007-9424.20160284

Video：

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Objective To explore the effect of partial splenic embolization on splenectomy plus devascularization of esophageal and gastric vein. Methods Twenty three cirrhosis patients with portal hypertension combined the hypersplenism (partial splenic embolization group), who received partial splenic embolization in our hospital from June 2010 to June 2015, as well as 30 cirrhosis patients with portal hypertension combined the hypersplenism without undergoing partial splenic embolization in the same period (non-partial splenic embolization group), were collected retrospectively. All patients underwent splenectomy plus devascularization of esophageal and gastric vein. Comparison of operation time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative total flow of abdominal drainage tube, postoperative gastrointestinal function recovery time, hospital stay, and the incidence of complication was performed. Results The operation time[(3.56±0.70) h vs. (1.78±0.28) h], intraoperative blood loss (900 mL vs. 250 mL), intraoperative blood transfusion volume (800 mL vs. 200 mL), postoperative total flow of abdominal drainage tube (450 mL vs. 150 mL), postoperative gastrointestinal function recovery time[(43.38±18.68) h vs. (27.60±12.39) h], hospital stay (12 d vs. 7 d), and incidence of incision infection[34.8% (8/23) vs. 10.0% (3/30)] of partial splenic embolization group were all higher or longer than those corresponding indexes of non-partial splenic embolization group (P < 0.05). All patients of 2 groups were followed up by telephone visit for 6-58 months, and the median was 28-month. There was no recurrence of gastrointestinal hemorrhage during the follow-up period. Conclusions Splenectomy is more difficult, and maybe has more intraoperative blood loss and complications for cirrhosis patients with portal hypertension combined the hypersplenism, who received partial splenic embolization ever. For these patents, the recovery time is longer. We should make choice of partial splenic embolization or splenectomy directly according to the patients' situation, to implement individualized treatment, so we can make the biggest benefit for patients.

Citation： DENG Chi-duo, QIN Huai-cheng, ZHONG Xian-rong, LIANG San-hai. Effect of Partial Splenic Embolization on Splenectomy plus Devascularization of Esopha-geal and Gastric Vein. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1112-1115. doi: 10.7507/1007-9424.20160284 Copy

1.	李明軍, 張傳汶, 接貴濤, 等.部分脾栓塞術治療脾機能亢進癥(附23例報告).醫學影像學雜志, 2001, 11(5):340-342.
2.	肖幼華, 藍小林, 方遠明, 等.部分脾栓塞術治療脾腫大、脾功能亢進的臨床觀察(附6例報告).贛南醫學院學報, 2004, 24(1):63-64.
3.	Xu RY, Liu B, Lin N. Therapeutic effects of endoscopic variceal ligation combined with partial splenic embolization for portal hypertension. World J Gastroenterol, 2004, 10(7):1072-1074.
4.	Ishikawa T, Abe S, Kojima Y, et al. Telaprevir-based triple therapy following partial splenic arterial embolization for chronic hepatitis C with thrombocytopenia can reduce carcinogenesis and improve hepatic function reserve. Exp Ther Med, 2015, 10(4):1334-1338.
5.	Helaly AZ, Al-Warraky MS, El-Azab GI, et al. Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism. APMIS, 2015, 123(12):1032-1039.
6.	陳志玉, 戴朝六.門靜脈高壓癥脾功能亢進的外科治療.中國普外基礎與臨床雜志, 2015, 22(7):884-888.
7.	余靈祥, 張紹庚, 郭曉東, 等.脾動脈栓塞術后出現嚴重粘連的脾切除手術體會.現代生物醫學進展, 2014, 14(17):3290-3292.
8.	王剛剛, 倪才方.部分脾栓塞治療脾亢的現狀.臨床肝膽病雜志, 2012, 28(2):99-102.
9.	Guan YS, Hu Y. Clinical application of partial splenic embolization. Sci World J, 2014, 2014:961345.
10.	Hadduck TA, Mc Williams JP. Partial splenic artery embolization in cirrhotic patients. World J Radiol, 2014, 6(5):160-168.
11.	楊華強, 張榮環, 萬楚成, 等.選擇性部分脾栓塞治療慢性特發性血小板減少性紫癜.臨床誤診誤治, 2009, 22(11):34-35.
12.	劉愛民, 雷德安, 楊平, 等.部分脾動脈栓塞術治療脾功能亢進的療效評價.重慶醫學, 2003, 32(2):170.
13.	袁莉莉, 朱西琪, 戴峰.兩種不同脾栓塞方法臨床結果對照研究.東南大學學報:醫學版, 2015, 34(2):247-250.
14.	龍圣根, 肖玉蘭, 郭路生.部分脾栓塞治療食道-胃底靜脈曲張和脾功能亢進.江西醫藥, 2007, 42(5):415-416.
15.	朱莉, 李明, 金滿春, 等.部分脾栓塞術對肝硬化患者門靜脈血流動力學的影響.南通大學學報:醫學版, 2010, 30(2):124-125.
16.	Masada T, Tanaka T, Sakaguchi H, et al. Coils versus gelatin particles with or without intraarterial antibiotics for partial splenic embolization:a comparative evaluation. J Vasc Interv Radiol, 2014, 25(6):852-858.
17.	陸建常, 潘少詠.部分性脾動脈栓塞術在治療脾功能亢進中的應用.微創醫學, 2007, 2(2):97-98.
18.	曹傳培, 孫勝, 汪峰.自體脾移植術后移植脾存活與免疫功能恢復的相關性研究.贛南醫學院學報, 2014, 34(6):874-876.
19.	姜洪池, 朱化強.脾移植的進展與前景.器官移植, 2010, 1(5):261-263.
20.	胡仁健, 秦紅軍, 程剛, 等.腹腔鏡下脾切除術的幾點探討.肝膽胰外科雜志, 2015, 27(2):143-145.
21.	趙大聰, 余暉, 李鑫, 等.副脾典型及不典型MRI表現分析.醫學影像學雜志, 2015, 25(7):1301-1303.
22.	鄧美海, 湯照峰, 許瑞云, 等.脾切除術與脾動脈栓塞術治療肝硬化脾亢療效的比較.中國現代醫學雜志, 2006, 16(12):1858-1860, 1863.
23.	張磊, 陳積圣.自體脾移植及食管橫斷吻合術治療門靜脈高壓癥的臨床與基礎研究:可供選擇的一種新療法的30年觀察.中國普外基礎與臨床雜志, 2013, 20(1):13-17.
24.	吳上興, 陳俊彪, 黃強欽, 等.自脾移植加食管橫斷吻合術治療肝硬化門脈高壓癥的臨床研究.大家健康, 2013, 7(3):102-103.
25.	唐羿, 於建鵬.保脾斷流術在肝功能不佳并門靜脈高壓上消化道出血患者中的應用效果分析.中國現代普通外科進展, 2015, 18(5):361-364.
26.	王東, 倪彥彬, 朱繼業, 等.保脾斷流術治療門靜脈高壓癥食管胃底靜脈曲張破裂出血的遠期療效觀察.中國普外基礎與臨床雜志, 2015, 22(11):1302-1304.

1. 李明軍, 張傳汶, 接貴濤, 等.部分脾栓塞術治療脾機能亢進癥(附23例報告).醫學影像學雜志, 2001, 11(5):340-342.
2. 肖幼華, 藍小林, 方遠明, 等.部分脾栓塞術治療脾腫大、脾功能亢進的臨床觀察(附6例報告).贛南醫學院學報, 2004, 24(1):63-64.
3. Xu RY, Liu B, Lin N. Therapeutic effects of endoscopic variceal ligation combined with partial splenic embolization for portal hypertension. World J Gastroenterol, 2004, 10(7):1072-1074.
4. Ishikawa T, Abe S, Kojima Y, et al. Telaprevir-based triple therapy following partial splenic arterial embolization for chronic hepatitis C with thrombocytopenia can reduce carcinogenesis and improve hepatic function reserve. Exp Ther Med, 2015, 10(4):1334-1338.
5. Helaly AZ, Al-Warraky MS, El-Azab GI, et al. Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism. APMIS, 2015, 123(12):1032-1039.
6. 陳志玉, 戴朝六.門靜脈高壓癥脾功能亢進的外科治療.中國普外基礎與臨床雜志, 2015, 22(7):884-888.
7. 余靈祥, 張紹庚, 郭曉東, 等.脾動脈栓塞術后出現嚴重粘連的脾切除手術體會.現代生物醫學進展, 2014, 14(17):3290-3292.
8. 王剛剛, 倪才方.部分脾栓塞治療脾亢的現狀.臨床肝膽病雜志, 2012, 28(2):99-102.
9. Guan YS, Hu Y. Clinical application of partial splenic embolization. Sci World J, 2014, 2014:961345.
10. Hadduck TA, Mc Williams JP. Partial splenic artery embolization in cirrhotic patients. World J Radiol, 2014, 6(5):160-168.
11. 楊華強, 張榮環, 萬楚成, 等.選擇性部分脾栓塞治療慢性特發性血小板減少性紫癜.臨床誤診誤治, 2009, 22(11):34-35.
12. 劉愛民, 雷德安, 楊平, 等.部分脾動脈栓塞術治療脾功能亢進的療效評價.重慶醫學, 2003, 32(2):170.
13. 袁莉莉, 朱西琪, 戴峰.兩種不同脾栓塞方法臨床結果對照研究.東南大學學報:醫學版, 2015, 34(2):247-250.
14. 龍圣根, 肖玉蘭, 郭路生.部分脾栓塞治療食道-胃底靜脈曲張和脾功能亢進.江西醫藥, 2007, 42(5):415-416.
15. 朱莉, 李明, 金滿春, 等.部分脾栓塞術對肝硬化患者門靜脈血流動力學的影響.南通大學學報:醫學版, 2010, 30(2):124-125.
16. Masada T, Tanaka T, Sakaguchi H, et al. Coils versus gelatin particles with or without intraarterial antibiotics for partial splenic embolization:a comparative evaluation. J Vasc Interv Radiol, 2014, 25(6):852-858.
17. 陸建常, 潘少詠.部分性脾動脈栓塞術在治療脾功能亢進中的應用.微創醫學, 2007, 2(2):97-98.
18. 曹傳培, 孫勝, 汪峰.自體脾移植術后移植脾存活與免疫功能恢復的相關性研究.贛南醫學院學報, 2014, 34(6):874-876.
19. 姜洪池, 朱化強.脾移植的進展與前景.器官移植, 2010, 1(5):261-263.
20. 胡仁健, 秦紅軍, 程剛, 等.腹腔鏡下脾切除術的幾點探討.肝膽胰外科雜志, 2015, 27(2):143-145.
21. 趙大聰, 余暉, 李鑫, 等.副脾典型及不典型MRI表現分析.醫學影像學雜志, 2015, 25(7):1301-1303.
22. 鄧美海, 湯照峰, 許瑞云, 等.脾切除術與脾動脈栓塞術治療肝硬化脾亢療效的比較.中國現代醫學雜志, 2006, 16(12):1858-1860, 1863.
23. 張磊, 陳積圣.自體脾移植及食管橫斷吻合術治療門靜脈高壓癥的臨床與基礎研究:可供選擇的一種新療法的30年觀察.中國普外基礎與臨床雜志, 2013, 20(1):13-17.
24. 吳上興, 陳俊彪, 黃強欽, 等.自脾移植加食管橫斷吻合術治療肝硬化門脈高壓癥的臨床研究.大家健康, 2013, 7(3):102-103.
25. 唐羿, 於建鵬.保脾斷流術在肝功能不佳并門靜脈高壓上消化道出血患者中的應用效果分析.中國現代普通外科進展, 2015, 18(5):361-364.
26. 王東, 倪彥彬, 朱繼業, 等.保脾斷流術治療門靜脈高壓癥食管胃底靜脈曲張破裂出血的遠期療效觀察.中國普外基礎與臨床雜志, 2015, 22(11):1302-1304.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Partial Splenic Embolization on Splenectomy plus Devascularization of Esopha-geal and Gastric Vein

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