Role of dissection of secondary branches of splenic pedicle in portal hypertension cases undergoing splenectomy
Autor: | Jiang-tao Li, Jiyu Li, Yan Chen, Ying Kong, Ying-bin Liu, Shu-You Peng, Wei-Hong Weng, Xiangsong Wu, Zhiwei Quan, De-Qing Chen, Yong Wang, Song-Gang Li, Xu-an Wang, Xiaozhou Fei, Jian-wei Wang, Zhi-Ping Zhang, Li-ping Cao |
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Rok vydání: | 2008 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Splenectomy Hilum (biology) Spleen Young Adult Hypertension Portal medicine Humans Aged Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Surgery Dissection medicine.anatomical_structure Splenic Hilum Treatment Outcome Pancreatic fistula Portal hypertension Female business Ligation |
Zdroj: | Chinese medical journal. 121(22) |
ISSN: | 2542-5641 |
Popis: | Background It is well known that conventional splenectomy, which requires careful handling and ligation of tissue of the splenic hilum, can easily cause complications such as splenic fever and pancreatic fistula. Here, we use the technique of dissection of the secondary branches of the splenic pedicle to handle the hilum in the portal hypertension patients who are subjected to splenectomy. Methods We retrospectively compared and analyzed the complications, postoperative hospital stay, operative time, and occurrence of hemorrhage in 121 patients with portal hypertension undergoing splenectomy and devascularization of the gastric cardia from January 1999 to December 2007. The selected cases consisted of 51 patients undergoing conventional splenectomy and 70 patients undergoing dissection of secondary branches of the splenic pedicle. In addition, we analyzed the relationship between size of the spleen and occurrence of complications. Results The incidence of pancreatic fistula and splenic fever (0/70 and 9/70) was lower in patients undergoing dissection of secondary branches of the splenic pedicle as compared with that of the conventional group (5/51 and 18/51 respectively). In addition, there was no significant difference in operative time and volume of blood loss between two groups. The spleen thickness of those patients who had pancreatic fistula and splenic fever was significantly greater than those without complications. Conclusions These results indicate that dissection of secondary branches of the splenic pedicle in portal hypertension patients undergoing splenectomy can decrease the incidence of splenic fever and pancreatic fistula, and shorten the postoperative hospital stay, especially in the patients with a large spleen. So dissection of secondary branches of the splenic pedicle is a valuable technique for splenectomy. |
Databáze: | OpenAIRE |
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