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Clinical Study of Laparoscopic Devascularization Combined with Endoscopic Esophageal Varix Ligation and Laparoscopic Modified Sugiura Surgery for Treatment of Portal Hypertension |
FENG Yi-bin, ZHANG Guang-ya, BIE Yu-kun,et al |
Department of General Surgery, the Ankang Central Hospital, Shaanxi 725000, Ankang, Shaanxi, China |
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Abstract 【Objective】To explore the clinical effect of laparoscopic devascularization combined with endoscopic esophageal varix ligation(EVL) and laparoscopic modified Sugiura surgery for the treatment of portal hypertension.【Methods】A total of 103 patients with portal hypertension was randomly divided into two groups: ,the Group A (underwent laparoscopic devascularization combined with endoscopic esophageal varix ligation(EVL) (n=55) and the Group B (underwent laparoscopic Sugiura operatio(n=48). The operation time, postoperative anal exhaust time, postoperative hospital stay, liver function Child-Pugh grade and esophageal varices were compared between the two groups.【Results】Compared with those of the Group B, the operative time, hospital stay and postoperative exhaust time in the Group A were shorter ,the difference was statistically significant (P<0.05) and there was no significant difference in blood loss and volume of drainage between the two groups (P>0.05). Six months after the operation, the esophageal varices degree and Child-Pugh classification in the two groups were better than that of pre-operation. Patients with Child-Pugh classification grade A in the Group A were more than that in the Group B (P=0.0300), and the incidence of hepatic encephalopathy was lower than that of the Group B, the difference was statistically significant (P<0.05).【Conclusion】Laparoscopic devascularization combined with endoscopic esophageal varix ligation(EVL) for the treatment of portal hypertension has advantages of shorter operation time, better recovery of liver and intestinal function with lower incidence of hepatic encephalopathy after operation, It is worthy of clinical popularization and application.
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Received: 08 September 2016
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[1] 周光文,杨连粤. 肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2015)[J].中国实用外科杂志,2015,35(10):1086-1090. [2] 贺新新,罗汉传,陈培升,等. 腹腔镜脾切除联合贲门周围血管离断术在门静脉高压症中的应用[J].中国普外基础与临床杂志,2013,23(7):772-775. [3] 姜青峰,王要轩,李珂,等. 腹腔镜脾切除联合贲门周围血管离断术治疗门静脉高压症临床分析[J].中华实用诊断与治疗杂志,2014,28(5):469-470+473. [4] 车小双,吕海龙,谢天皓,等. 门静脉高压不同手术后并发症分析[J].中国现代普通外科进展,2013,16(9):708-711. [5] 徐继威,张耀明,宋越,等. 完全腹腔镜下脾切除联合贲门周围血管离断术治疗门脉高压症[J].中国微创外科杂志,2015,15(7):601-603. [6] 于智勇,许程伟,张艮龙. 分流联合断流术治疗门静脉高压疗效分析[J].蚌埠医学院学报,2011,36(8):828-830. [7] 刘滨洋,刘祖定,伍家发,等. 完全腹腔镜脾切除断流术在肝硬化门静脉高压症中的应用效果[J].当代医学,2015,21(8):68-69. [8] Ailawadi G, Yahanda A, Dimick JB,et al.Hand-assisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation [J].Surg,2002,132(4): 689-696. [9] 潘孟,蔡小勇,卢榜裕,等. 腹腔镜下改良Sugiura手术治疗门静脉高压症的临床研究[J].中国内镜杂志,2013,19(12):1287-1290. [10] 李国库,王丽华. 内镜联合腹腔镜治疗门静脉高压症[J].航空航天医药,2010,21(5):656-657. [11] 张绪清. 肝性脑病的预防与治疗进展[J].实用肝脏病杂志,2014,17(2):121-124. [12] 李贞茂,李良平,张初民. 急诊内镜下套扎应用于肝硬化食管静脉曲张破裂出血的疗效及安全性评价[J].实用医院临床杂志,2012,9(6):55-57. |
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