partial splenectomy

Spleen injury or rupture caused by direct or indirect external force may occur in closed abdominal injury (abdominal skin integrity, abdominal cavity without contact with the outside world), or open abdominal injury (abortion of abdominal skin loss) The abdominal cavity communicates with the outside through the wound). At this time, partial splenectomy can be performed to save the spleen function. Treatment of diseases: traumatic spleen rupture spleen cyst Indication 1. The upper or lower part of the spleen can not be sutured. 2. Limited to benign cysts in a certain part of the spleen. 3. Localized intrasplenic hematoma. 4. The vascular damage of a certain leaf and segment of the spleen can not be repaired, and some spleen blood supply disorders have obvious boundaries in the spleen. This part of the spleen should be removed. 5. Part of the spleen injury, the age is below 60 years old and the vital organs are basically intact, allowing the reserved spleen surgery to proceed smoothly. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure (1) Treatment of the corresponding spleen blood vessels: After the spleen and stomach ligaments are incision, if there are not many spleen pedicle tissues, the direction and distribution of the clear blood vessels can be distinguished, and the corresponding blood vessels can be treated accordingly; otherwise, the corresponding regional blood vessels can be treated close to the spleen. (2) Judgment of the proposed tangential line: After the corresponding vascular treatment, the spleen shows a clear boundary between the blood supply disorder and the good blood supply, here the relative avascular plane. (3) Dissection of the spleen: From the relative avascular plane, the skin is retracted to the healthy side with a good blood flow of 0.5 cm, the spleen capsule is cut, and the spleen is cut with an ultrasonic knife or a shank, and the blood vessel is removed, and the jaw is disconnected. The filaments were ligated close to the healthy side until the spleen was removed, and the excised spleen was placed in 4 ° C heparin saline. (4) Treatment of the residual spleen section: If there is a little oozing, the section can be treated by the U-shaped suture method. (5) Peritonealization of the section: the large omentum covering section of the free vascular pedicle is fixed, and several needles are sutured around the thin needle of the round needle to achieve the purpose of peritonealization of the section. The spleen section can also be treated by spleen capsule transplantation, and the cut spleen is peeled off into the spleen membrane in 4°C heparin saline, just like the size of the spleen section, which is covered on the spleen section, and the periphery is fixed by silk thread. (6) Drainage: After clearing the abdominal cavity without bleeding and no other damage, carefully wash the abdominal cavity with warm saline, and place two soft hoses on the spleen to drain, and lead out according to the principle of low-level shortcut.

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