ObjectiveTo study the feasibility of laparoscopic assisted splenectomy for massive splenomegaly and devascularization in the treatment of patients with cirrhosis and portal hypertension.MethodA retrospective study was carried out on 12 patients who underwent laparoscopic assisted splenectomy and devascularization from October 2003 to January 2010.ResultsThe operation was successfully carried out in eight patients.The remaining four patients were converted to open surgery due to intra-operative bleeding.The mean operation times for the 12 patients and the 8 patients who underwent laparoscopic surgery were 350 min (range,190-470 min) and 313 min (range,190-410 min),respectively.The corresponding mean intra-operative blood losses were 1300 ml (range,200-2200 ml) and 700 ml (range,200-1700 ml),respectively.For the 8 patients who received laparoscopic surgery,flatus were passed 3-5 days after operation,and the postoperative hospitalization was 10-20 days.ConclusionsLaparoscopic assisted splenectomy for massive splenomegaly and devascularization is feasible.It is a treatment option for patients with cirrhosis and portal hypertension.

Objective To investigate the risk factors for biliary stricture within two years after orthotopic liver transplantation,and analyze the survival.Methods A retrospective analysis was performed for the data of 495 patients who underwent liver transplantation at Liver Transplantation Center of The First Hospital of Jilin University from January 2014 to January 2022,and according to the presence or absence of biliary stricture within two years after liver transplantation,the 495 patients were divided into stricture group with 89 patients and non-stricture group with 406 patients.The risk factors for biliary stricture and prognosis were analyzed.The independent-samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.Univariate and multivariate Cox regression analyses were used for the analysis of risk factors,and the Kaplan-Meier method was used for survival analysis.Results Recipient sex(hazard ratio[HR]=1.808,95%confidence interval[CI]:1.055-3.098,P=0.031),preoperative total bilirubin of the recipient(HR=1.002,95%CI:1.001-1.003,P=0.001),cold ischemia time(HR=1.003,95%CI:1.001-1.005,P=0.007),history of abdominal surgery for the recipient(HR=3.851,95%CI:2.273-6.524,P<0.001),and mismatch of donor-recipient bile ducts(HR=1.962,95%CI:1.041-3.698,P=0.037)were identified as independent risk factors for biliary stricture within two years after transplantation.The median follow-up time was 4.09 years,and the 1-,3-,and 5-year survival rates were 92.7%,80.5%,and 75.4%,respectively,after liver transplantation.The onset of biliary stricture within two years after liver transplantation had no significant impact on the survival of patients undergoing orthotopic liver transplantation.Conclusion Recipient sex,preoperative total bilirubin of the recipient,cold ischemia time,history of abdominal surgery for the recipient,and mismatch of donor-recipient bile ducts are independent risk factors for biliary stricture within two years after transplantation.The onset of biliary stricture within two years after transplantation does not affect the survival time of patients undergoing orthotopic liver transplantation.