RESUMO
Objective To summarize the experience of laparoscopic massive splenectomy combined with selective pericardial devascularization using endoligature technique. Methods By using silk ligature and hamonic scapel or the LigaSure, 6 patients with portal hypertension and esophagogastric varices underwent laparoscopic massive splenectomy and selective pericardial devascularization. Results All the operations were completed successfully under laparoscope. The intraoperative blood loss was 80~200 ml (mean, 130 ml). None of the patients required blood transfusion or conversion to open procedure. The operation time was 150~210 min (mean, 190 min). There were no surgical complications. All the patients resumed to normal activities 5 days after operation. Follow-up observations for 3~10 months (mean, 8 months) revealed no recurrent variceal hemorrhage. Conclusions Laparoscopic massive splenectomy combined with selective pericardial devascularization using endoligature technique is a feasible, effective, safe, little hemorrhagic, and minimally invasive procedure for portal hypertension with esophagogastric varices.