臨床外科78巻11号

2023年10月発行

増刊号 —消化器・一般外科—研修医・専攻医サバイバルブック—術者として経験すべき手技のすべて Ⅵ．肝胆膵

脾摘術：開腹手術

著者： 吉田寛¹ 清水哲也¹ 川野陽一¹ 上田純志¹ 松下晃¹ 吉岡正人¹ 川島万平¹ 谷合信彦¹ 真々田裕宏¹

所属機関： ¹日本医科大学消化器外科

ページ範囲：P.260 - P.262

ビギナーへのアドバイス
◯巨脾に対する脾摘では躊躇せずに皮膚を大きく切開し，良好な視野を展開することが重要である．
◯術早期に脾動脈結紮し出血量を軽減させることは重要だが，視野が悪い場合は無理をせずに後で行う．

参考文献

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12）Hassab MA：Gastroesophageal decongestion and splenectomy in the treatment of esophageal varices in bilharzial cirrhosis：further studies with a report on 355 operations. Surgery 61：169-176, 1967

13）吉田　寛：門脈圧亢進症における脾静脈血行動態の検討．日消誌88：2763-2770，1991

14）Yoshida H, et al：Shunting and nonshunting procedures for the treatment of esophageal varices in patients with idiopathic portal hypertension. Hepatogastroenterology 57：1139-1144, 2010

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16）Kawanaka H, et al：Impact of antithrombin III concentrates on portal vein thrombosis after splenectomy in patients with liver cirrhosis and hypersplenism. Ann Surg 251：76-83, 2010