Laparoscopic splenectomy and azygoportal disconnection with intraoperative endoscopic variceal ligation in the prevention of postoperative recurrent bleeding
10.3760/cma.j.cn113855-20220828-00533
- VernacularTitle:腹腔镜脾切除断流联合术中内镜下套扎术防治术后食管胃底静脉曲张破裂再出血
- Author:
Baohuan ZHOU
1
;
Guoqing JIANG
;
Dousheng BAI
;
Jianjun QIAN
;
Shengjie JIN
;
Chi ZHANG
Author Information
1. 扬州大学临床医学院肝胆外科，扬州 225001
- Keywords:
Hypertension,portal;
Esophagel and gastric varices;
Hemorrhage;
Endoscopic variceal ligation
- From:
Chinese Journal of General Surgery
2023;38(7):510-514
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of laparoscopic splenectomy and azygoportal disconnection (LSD) with intraoperative endoscopic variceal ligation (LSDL) in the treatment of esophagogastric variceal bleeding (EVR).Method:In this study,90 cirrhotic patients with esophagogastric variceal bleeding (EVB) were divided to receive either LSD ( n=45) or LSDL ( n=45) from Jan 2020 and Dec 2021. Results:There were no significant differences in estimated blood loss, incidence of blood transfusion, time to first flatus, off-bed activity and postoperative hospital stay between the two groups (all P>0.05). Compared with LSD group, operation time was longer in LSDL group[ (140±21) min vs. (150±19) min, t=2.420, P=0.018]. LSDL was associated with significantly decreased EVR rate in one year follow-up (2% vs. 18%, P=0.030). Univariate analysis and multivariate logistic regression revealed that LSDL was a significant independent protective factor for EVR as compared with LSD ( P<0.05). Conclusion:LSDL procedure is not only technically feasible and safe, it also contributed to lower postoperative EVR risk than single LSD.
