【摘要】 目的探讨术前依据CT血管成像(CTA)制定个体化手术方案在腹腔镜脾切除术中的应用。方法对40例患者术前行脾动脉CTA检查,制定个体化手术方案。分散型脾动脉行脾蒂二级血管离断术,集中型脾动脉行脾蒂一级血管离断术;脾动脉位于胰腺上缘,先行分离并结扎脾动脉主干,脾动脉位于胰腺后方或胰尾内,先离断脾周围韧带和剥离胰尾,再显露脾蒂血管。结果 40例患者顺利完成腹腔镜脾切除术,术中出血减少,手术时间缩短。结论术前CTA可明确脾动脉及其分支解剖类型及其走行,指导制定个性化手术方案,增强手术的安全性。更多还原

【Abstract】 Objective To explore the application of developing individualized surgical treatment based on preoperative CTA in Laparoscopic Splenectomy.Methods To do the splenic artery CTA examination before operation and guide the development of individualized surgical treatment:using the technique of spleen subpedicle severance in distributed splenic artery and using the technique of spleen pedicle severance in centralized splenic artery;Splenic artery was located above the pancreatic tail,and to isolate it first and to do ligation of splenic artery;Splenic artery was located in the pancreas or behind pancreas tail,and to cut the surrounding ligaments first and to peel off the pancreas tail,and then to expose the splenic pedicle.Results 40 patients were successfully completed laparoscopic splenectomy,bleeding was reduced and the operation time was shorten.Conclusion CTA can identify splenic artery and its branches anatomy type and traveling before LS,thereby to guide the development of individualized surgical reatment,it can increase the safety of LS.更多还原