ABSTRACT
ObjectiveTo investigate the incidence rate and risk factors for the complications after laparoscopic splenectomy in patients with portal hypertension. MethodsThe clinical data of 83 patients with portal hypertension, who were admitted to our hospital and underwent laparoscopic splenectomy from June 2009 to December 2014, were analyzed retrospectively. The incidence rate of the complications was analyzed using the Clavien-Dindo classification system and the risk factors for the complications were analyzed using chi-square test and logistic regression method. ResultsThe incidence rate of postoperative complications was 24.10% (20/83). According to the Clavien-Dindo classification system, the numbers of patients with grade Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ complications were 5, 3, 10, 2, and 0, respectively. The patients undergoing total laparoscopic splenectomy had a significantly higher incidence rate of postoperative complications than those undergoing hand-assisted laparoscopic splenectomy (32.59% vs 15.00%, χ2=3.966, P=0.046). According to the univariate analysis, the Child-Pugh class, application of the hand-assisted device, gastroesophageal vein ligation, and American Society of Anesthesiologists (ASA) grade were all risks factors for the postoperative complications (all P＜0.05). Further analysis using multiple logistic regression illustrated that Child-Pugh class B and ASA grade Ⅲ were independent risk factors for the postoperative complications (OR=0.328, 95%CI: 0.129~0.834, P＜0.05; OR=0.294, 95%CI: 0.150~0.573, P＜0.05). ConclusionPatients with portal hypertension undergoing laparoscopic splenectomy have a high incidence of postoperative complications and the occurrence of the complications is closely associated with the Child-Pugh class and the ASA grade.
ABSTRACT
ObjectiveTo observe the effects of different suture techniques on complications after choledochojejunostomy. MethodsA retrospective analysis was performed on the clinical data of 162 patients who underwent choledochojejunostomy from January 2005 to December 2014 in our hospital. The patients were divided into group A undergoing simple interrupted suture (n=68), group B undergoing simple continuous suture (n=45), and group C undergoing parachute type continuous suture (n=49). The intraoperative conditions and postoperative complications were compared between the three groups. Comparison of continuous data between the three groups was made by ANOVA and pairwise comparison between any two groups was made by LSD t-tests; comparison of categorical data between the groups was made by chi-square test. ResultsThe anastomosis time and the rate of T-tube insertion showed significant differences between the three groups (P＜0.05). Groups B and C had significantly shorter anastomosis time than group A(P＜0.001), but there was no significant difference in the anastomosis time between groups B and C (P＞0.05). Among the three groups, group A had the highest rate of T-tube insertion; group B had the second highest rate; group C had the lowest rate. Significant differences were found between any two groups in the rate of T-tube insertion by pairwise comparison (P＜0.05). However, there were no significant differences between the three groups in the incidence rates of postoperative bile leakage and choleperitonitis (P＞0.05). There was significant difference in biliary stricture between the three groups in the follow-up examination 6 months after surgery (P＜0.001) and the differences analyzed by pairwise comparison were also significant (P＜0.05). Among the three groups, the degree of biliary stricture in the group A was the highest and that in the group C was the lowest. ConclusionParachute-type continuous suture is a fine suture technique for choledochojejunostomy, which can reduce the anastomosis time, the rate of T-tube insertion, and the degree of biliary stricture.
ABSTRACT
ObjectiveTo observe the effects of different suture techniques on complications after choledochojejunostomy. MethodsA retrospective analysis was performed on the clinical data of 162 patients who underwent choledochojejunostomy from January 2005 to December 2014 in our hospital. The patients were divided into group A undergoing simple interrupted suture (n=68), group B undergoing simple continuous suture (n=45), and group C undergoing parachute type continuous suture (n=49). The intraoperative conditions and postoperative complications were compared between the three groups. Comparison of continuous data between the three groups was made by ANOVA and pairwise comparison between any two groups was made by LSD t-tests; comparison of categorical data between the groups was made by chi-square test. ResultsThe anastomosis time and the rate of T-tube insertion showed significant differences between the three groups (P＜0.05). Groups B and C had significantly shorter anastomosis time than group A(P＜0.001), but there was no significant difference in the anastomosis time between groups B and C (P＞0.05). Among the three groups, group A had the highest rate of T-tube insertion; group B had the second highest rate; group C had the lowest rate. Significant differences were found between any two groups in the rate of T-tube insertion by pairwise comparison (P＜0.05). However, there were no significant differences between the three groups in the incidence rates of postoperative bile leakage and choleperitonitis (P＞0.05). There was significant difference in biliary stricture between the three groups in the follow-up examination 6 months after surgery (P＜0.001) and the differences analyzed by pairwise comparison were also significant (P＜0.05). Among the three groups, the degree of biliary stricture in the group A was the highest and that in the group C was the lowest. ConclusionParachute-type continuous suture is a fine suture technique for choledochojejunostomy, which can reduce the anastomosis time, the rate of T-tube insertion, and the degree of biliary stricture.