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Laparoscopic splenectomy for preserving blood flow of the gastric remnant after distal gastrectomy utilizing the magnified view of the laparoscope : report of a case Kohei ISHIOKA 1 , Saiho KO 1 , Takahiro YOSHIKAWA 1 , Tomohide MUKOGAWA 1 , Hirofumi ISHIKAWA 1 , Akihiko WATANABE 1 1Department of Surgery, Nara Prefectural Nara Hospital Keyword: 幽門側胃切除術後 , 腹腔鏡下手術 , 脾摘術 pp.345-350
Published Date 2013/5/15
DOI https://doi.org/10.11477/mf.4426100952
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We present a case in which laparoscopic total splenectomy was performed to ressect a splenic tumor after open distal gastrectomy for gastric cancer 9 years ago. The patient was a 79-year-old man with chronic hepatitis C. A splenic tumor of the 24mm size was pointed out in CT scan for screening of liver tumors, and the lesion showed high accumulation in FDG-PET suggesting malignant lymphoma of the spleen. Laparoscopic splenectomy was performed for the purpose of diagnosis and treatment, while splenectomy in patients with distal gastrectomy may cause severe ischemia of gastric remnant. Before surgery, the position of posterior gastric and short gastric arteries were identified by MD-CT, and these vessels were carefully preserved under the magnified view of laparoscopic surgery. His postoperative course was uneventful without gastric ischemia. This may be the first report of laparoscopic splenectomy in a patient after distal gastrectomy.


Copyright © 2013, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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