Laparoscopic splenectomy with behind splenic hilus tunnel-building technique_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Jinzheng , YOU Ke , TU Bing , GONG Jianping ,  LIU Zuojin

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;

Corresponding?author：

LIU Zuojin, Email: liuzuojin66@hotmail.com

Keywords：

laparoscopic splenectomy; behind splenic hilum tunnel-building technique

DOI：

10.7507/1007-9424.201802062

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To discuss surgical skills and clinical value of laparoscopic splenectomy with behind splenic hilus tunnel-building technique. Method The clinical data of 1 patient with HBV-related hepatic cirrhosis combined splenomegaly and hypersplenism treated in the Second Affiliated Hospital of Chongqing Medical University was discussed and summarized. Results The patient underwent the laparoscopic splenectomy with surgical approach of from bottom to top, front to back, and shallow to deep. The key point of the tunnel-building technique was fully exposed the upper and lower poles of the splenic pedicle. The operative time was 70 min, the intraoperative blood loss was 50 mL, and the discharge time was 5 d after operation. Conclusion Laparoscopic splenectomy with behind splenic hilum tunnel-building technique is safe and feasible, especially for beginners.

Citation： LI Jinzheng, YOU Ke, TU Bing, GONG Jianping, LIU Zuojin. Laparoscopic splenectomy with behind splenic hilus tunnel-building technique. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(3): 338-341. doi: 10.7507/1007-9424.201802062 Copy

1.	楊鎮. 我國門靜脈高壓癥外科治療的現況和展望. 臨床肝膽病雜志, 2016, 32(2): 250-253.
2.	楊鎮, 萬赤丹, 鄧小榮. 腹腔鏡門靜脈高壓癥外科治療發展與新斷流術. 中華普外科手術學雜志 (電子版), 2017, 11(3): 181-184.
3.	Delaitre B, Maignien B. [Splenectomy by the laparoscopic approach. Report of acase]. Presse Med, 1991, 20(44): 2263.
4.	Misiakos EP, Bagias G, Liakakos T, et al. Laparoscopic splenectomy: Current concepts. World J Gastrointest Endosc, 2017, 9(9): 428-437.
5.	Tada K, Ohta M, Saga K, et al. Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. Surg Today, 2018, 48(2): 180-185.
6.	Moris D, Dimitriou N, Griniatsos J. Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review. In Vivo, 2017, 31(3): 291-302.
7.	展翰翔, 胡三元. 腹腔鏡脾切除術的要點與難點. 腹腔鏡外科雜志, 2016, (08): 567-569.
8.	別平, 陳健. 腹腔鏡脾切除術. 中華肝臟外科手術學電子雜志, 2015, (3): 142-145.
9.	Tsamalaidze L, Stauffer JA, Permenter SL, et al. Laparoscopic Splenectomy for Massive Splenomegaly: Does Size Matter? J Laparoendosc Adv Surg Tech A, 2017, 27(10): 1009-1014.
10.	王廣義, 蔣超. 腹腔鏡脾切除技術演進與實踐. 中華肝臟外科手術學電子雜志, 2017, 6(4): 241-244.
11.	陳羅飛. 腹腔鏡下脾切除術及相關手術研究進展. 現代醫藥衛生, 2017, 33(10): 1487-1490.
12.	張焱輝, 蔣國慶, 唐俊, 等. 腹腔鏡下巨脾切除加賁門周圍血管離斷術治療肝硬化門靜脈高壓的療效分析. 中華普外科手術學雜志 (電子版), 2017, 11(5): 414-416.
13.	劉新文. 腹腔鏡下巨脾切除聯合賁門周圍血管離斷術治療肝硬化門靜脈高壓 30 例. 中國現代普通外科進展, 2016, 19(4): 310-312.
14.	單志東, 牟一平, 楊瑾, 等. 門靜脈高壓癥的腔鏡外科治療. 肝膽外科雜志, 2017, 25(5): 396-397.
15.	向俊西, 張安澎, 呂毅, 等. 腹腔鏡脾切除術的技術發展及并發癥的處理. 腹腔鏡外科雜志, 2017, 22(8): 627-630.
16.	萬赤丹, 唐勇. " 隧道法”腹腔鏡脾切斷流術. 中華普外科手術學雜志 (電子版), 2017, 11(3): 189.
17.	何成, 劉作金. 脾下極入路脾蒂控制法在全腔鏡脾切除術中的應用. 局解手術學雜志, 2017, 26(5): 330-333.
18.	唐勇, 王文靜, 張宇, 等. 腹腔鏡脾切除加賁門周圍血管離斷術治療門靜脈高壓癥的療效評價. 中華普通外科雜志, 2016, 31(2): 93-96.
19.	Gon?alves D, Morais M, Costa-Pinho A, et al. Validation of a difficulty?grading?score?in?laparoscopic?splenectomy. J Laparoendosc Adv Surg Tech A. 2017 Oct 11. doi: 10.1089/lap.2017.0478. [Epub ahead of print].
20.	李濤, 楊鎮. 精準醫學時代門靜脈高壓癥新斷流術的進展. 臨床外科雜志, 2017, 25(1): 30-31, 32.
21.	Toro A, Vitale M, Livera D, et al. Is Laparoscopy Really Advantageous for Splenectomy Patients? World J Surg, 2018, 42(3): 902.
22.	Sakamoto K, Honda G, Kurata M, et al. Safe approach to the splenic hilum by first mobilizing the pancreatic tail in laparoscopic splenectomy. Asian J Endosc Surg, 2017, 10(1): 83-86.
23.	Somasundaram SK, Massey L, Gooch D, et al. Laparoscopic splenectomy is emerging ‘gold standard’ treatment even for massive spleens. Ann R Coll Surg Engl. 2015 Jul 9: 1-4. [Epub ahead of print].
24.	許桐林, 邱烽, 蔡衛華. 早期應用低分子肝素加阿司匹林預防肝硬化脾臟切除術后門靜脈血栓形成. 南京醫科大學學報 (自然科學版), 2017, (12): 1644-1645.
25.	Jiang GQ, Bai DS, Chen P, et al. Risk Factors for Portal Vein System Thrombosis After Laparoscopic Splenectomy in Cirrhotic Patients with Hypersplenism. J Laparoendosc Adv Surg Tech A, 2016, 26(6): 419-423.
26.	Qian YY, Li K. The early prevention and treatment of PVST after laparoscopic splenectomy: A prospective cohort study of 130 patients. Int J Surg, 2017, 44: 147-151.

1. 楊鎮. 我國門靜脈高壓癥外科治療的現況和展望. 臨床肝膽病雜志, 2016, 32(2): 250-253.
2. 楊鎮, 萬赤丹, 鄧小榮. 腹腔鏡門靜脈高壓癥外科治療發展與新斷流術. 中華普外科手術學雜志 (電子版), 2017, 11(3): 181-184.
3. Delaitre B, Maignien B. [Splenectomy by the laparoscopic approach. Report of acase]. Presse Med, 1991, 20(44): 2263.
4. Misiakos EP, Bagias G, Liakakos T, et al. Laparoscopic splenectomy: Current concepts. World J Gastrointest Endosc, 2017, 9(9): 428-437.
5. Tada K, Ohta M, Saga K, et al. Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. Surg Today, 2018, 48(2): 180-185.
6. Moris D, Dimitriou N, Griniatsos J. Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review. In Vivo, 2017, 31(3): 291-302.
7. 展翰翔, 胡三元. 腹腔鏡脾切除術的要點與難點. 腹腔鏡外科雜志, 2016, (08): 567-569.
8. 別平, 陳健. 腹腔鏡脾切除術. 中華肝臟外科手術學電子雜志, 2015, (3): 142-145.
9. Tsamalaidze L, Stauffer JA, Permenter SL, et al. Laparoscopic Splenectomy for Massive Splenomegaly: Does Size Matter? J Laparoendosc Adv Surg Tech A, 2017, 27(10): 1009-1014.
10. 王廣義, 蔣超. 腹腔鏡脾切除技術演進與實踐. 中華肝臟外科手術學電子雜志, 2017, 6(4): 241-244.
11. 陳羅飛. 腹腔鏡下脾切除術及相關手術研究進展. 現代醫藥衛生, 2017, 33(10): 1487-1490.
12. 張焱輝, 蔣國慶, 唐俊, 等. 腹腔鏡下巨脾切除加賁門周圍血管離斷術治療肝硬化門靜脈高壓的療效分析. 中華普外科手術學雜志 (電子版), 2017, 11(5): 414-416.
13. 劉新文. 腹腔鏡下巨脾切除聯合賁門周圍血管離斷術治療肝硬化門靜脈高壓 30 例. 中國現代普通外科進展, 2016, 19(4): 310-312.
14. 單志東, 牟一平, 楊瑾, 等. 門靜脈高壓癥的腔鏡外科治療. 肝膽外科雜志, 2017, 25(5): 396-397.
15. 向俊西, 張安澎, 呂毅, 等. 腹腔鏡脾切除術的技術發展及并發癥的處理. 腹腔鏡外科雜志, 2017, 22(8): 627-630.
16. 萬赤丹, 唐勇. " 隧道法”腹腔鏡脾切斷流術. 中華普外科手術學雜志 (電子版), 2017, 11(3): 189.
17. 何成, 劉作金. 脾下極入路脾蒂控制法在全腔鏡脾切除術中的應用. 局解手術學雜志, 2017, 26(5): 330-333.
18. 唐勇, 王文靜, 張宇, 等. 腹腔鏡脾切除加賁門周圍血管離斷術治療門靜脈高壓癥的療效評價. 中華普通外科雜志, 2016, 31(2): 93-96.
19. Gon?alves D, Morais M, Costa-Pinho A, et al. Validation of a difficulty?grading?score?in?laparoscopic?splenectomy. J Laparoendosc Adv Surg Tech A. 2017 Oct 11. doi: 10.1089/lap.2017.0478. [Epub ahead of print].
20. 李濤, 楊鎮. 精準醫學時代門靜脈高壓癥新斷流術的進展. 臨床外科雜志, 2017, 25(1): 30-31, 32.
21. Toro A, Vitale M, Livera D, et al. Is Laparoscopy Really Advantageous for Splenectomy Patients? World J Surg, 2018, 42(3): 902.
22. Sakamoto K, Honda G, Kurata M, et al. Safe approach to the splenic hilum by first mobilizing the pancreatic tail in laparoscopic splenectomy. Asian J Endosc Surg, 2017, 10(1): 83-86.
23. Somasundaram SK, Massey L, Gooch D, et al. Laparoscopic splenectomy is emerging ‘gold standard’ treatment even for massive spleens. Ann R Coll Surg Engl. 2015 Jul 9: 1-4. [Epub ahead of print].
24. 許桐林, 邱烽, 蔡衛華. 早期應用低分子肝素加阿司匹林預防肝硬化脾臟切除術后門靜脈血栓形成. 南京醫科大學學報 (自然科學版), 2017, (12): 1644-1645.
25. Jiang GQ, Bai DS, Chen P, et al. Risk Factors for Portal Vein System Thrombosis After Laparoscopic Splenectomy in Cirrhotic Patients with Hypersplenism. J Laparoendosc Adv Surg Tech A, 2016, 26(6): 419-423.
26. Qian YY, Li K. The early prevention and treatment of PVST after laparoscopic splenectomy: A prospective cohort study of 130 patients. Int J Surg, 2017, 44: 147-151.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic splenectomy with behind splenic hilus tunnel-building technique

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