ABSTRACT
ObjectiveTo study the Resultsof splenectomy for recurrent hypersplenism after splenic arterial embolization. MethodsA retrospective analysis was carried on 12 p1atients who underwent splenectomy for recurrent hypersplenism after splenic arterial embolization which had been carried out in 51 patients at this hospital from Jan. 2001 to Dec. 2008. ResultsSplenectomy was successfully carried out in all the 12 patients. The operative time ranged from 90 to 240 minutes. The mean blood transfusion was 810 ml. There was 1 case of pancreatic leakage after the operation, which healed with drainage for 4 weeks. One patient developed upper gastrointestinal hemorrhage 14 months after the operation, and he received a meso-caval shunt. Conclusion We should select patients carefully for splenic arterial embolization as splenectomy after splenic arterial embolization is difficult.
ABSTRACT
Objective To explore the safety, feasibility, and techniques of hand-assisted laparoscopic splenectomy (HSLS) for massive splenomegaly. Methods Between January 2005 and December 2006, 40 patients with massive splenomegaly owning to portal hypertension were treated with HSLS or open splenectomy (OS). The two groups were comparable in age, sex, hepatic function by Child classification, and size of the spleen. Results No serious complications occurred in both the groups. Compared with the OS group, patients in the HALS group had more blood loss [ (312?61) ml vs (235?105) ml, t=2.583, P=0.014], longer operation time [(95?20) min vs (73?16) min, t=3.832, P=0.000], earlier recovery of intestinal function [(48?1) h vs (98?1) h, t=-153.093, P=0.000], and shorter postoperative hospital stay [(6?2) d vs (10?2) d, t=-6.124, P=0.000]. Conclusions HSLS is feasible and safe for patients with massive splenomegaly. Despite a longer operation time, the procedure is superior in postoperative recovery.