Clinical Value of Intra-abdominal fluid Monitoring after Laparoscopic Splenectomy / 中国微创外科杂志

ABSTRACT

Objective To investigate the approaches and clinical value of intra-abdominal fluid monitoring after laparoscopic splenectomy (LS). Methods We collected the data of 63 cases of LS performed in the West China Hospital from November 2005 to August 2008,and analyzed the level of amylase in intra-abdominal fluid,changes of color,volume,and characteristics of the drainage fluid,as well as the results of germiculture and ultrasonography. Results Among the cases,post-LS complications were detected by intra-abdominal fluid monitoring in 4 cases early after the surgery. In the four cases,2 patients showed hemorrhagic fluid (over 40 ml/h),and then was found having postoperative bleeding in the splenogastric ligament by abdominal exploration in 12 hours. In the other 2 patients,ravidous drainage fluid was detected in 6 days after the operation,and increased levels of amylase (15 189 and 9206 U/L,respectively) was revealed while germiculture was negative; pancreatic fistula (PF) was then diagnosed and somatostatin was administered. Of the 2 patients who developed PF,intra-abdominal drainage was patent in 1,and the drainage tube was withdrawn in 20 days; for the other cases who had non-patent drainage,ultrasonography-guided percutaneous puncture catheter drainage was performed,and the drainage tube was taken out in 2 months. Conclusions LS is safe,reliable,and minimally invasive. Postoperative monitoring of intra-abdominal fluid is valuable for early detection of post-LS complications.