A comparative study between hand-assisted laparoscopic splenectomy and open splenectomy in combination with pericardial devascularization to treat portal hypertension
10.3760/cma.j.issn.1007-8118.2011.04.005
- VernacularTitle:手助腹腔镜与开腹脾切除、贲门周围血管离断术的临床分析
- Author:
Chang LIU
;
Jun XU
;
Yanchao JI
;
Bei SUN
- Publication Type:Journal Article
- Keywords:
Hand-assisted laparoscopy;
Portal hypertension;
Cirrhosis;
Splenectomy;
Pericardial devascularization
- From:
Chinese Journal of Hepatobiliary Surgery
2011;17(4):285-288
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the changes in liver function and the efficacy of either hand-assisted laparoscopic surgery (HALS) or open splenectomy (OS) in combination with pericardial devascularization in the treatment of portal hypertension. MethodsThe clinical data of 94 patients who received splenectomy combined with pericardial devascularization to treat portal hypertension due to cirrhosis from Jan 2002 to May 2008 were analyzed retrospectively. 56 patients received OS and 38patients HALS. The operating time, intraoperative blood loss, postoperative complications, liver dysfunction and mortality were analyzed according to the Child's grading. ResultsThere was no difference in the operating time between HALS and OS (P＞0. 05). The intraoperative blood loss and postoperative complications were 5.6% and 10.8%, respectively (P＜0. 05). There was no significant difference in the serum ALT between HALS and OS, but there was a significant difference in the ALB (P＜0. 05). The AST also had a significant difference on postoperative day 5 (P＜0. 05). The serum ALT and AST were elevated after HALS, but there was a significant difference only for AST (P＜0.05). The serum ALT and AST in OS were significantly higher after than before operation (P＜0. 05). The serum ALB in OS was significantly lower after operation (P＜0.05), but it was significantly lower only on postoperative days 1 and 3 (P＜0.05) in HALS. ConclusionsCompared with OS, HALS combined with pericardial devascularization caused less damage to the intestinal tract and the liver function. It is a feasible and safe operation and it had fewer postoperative complications.
