Modified hand-assited laparoscopic splenectomy plus pericardial devascularization for the treatment of cirrhotic portal hypertension / 中华普通外科杂志

ABSTRACT

ObjectiveTo evaluate the safety and efficacy of a modified hand-assited laparoscopic splenectomy (HALS) plus pericardial devascularization for the treatment of cirrhotic portal hypertension.MethodsFrom March 2009 to Dec 2011,modified hand-assited laparoscopic splenectomy plus pericardial devascularization was performed on 47 patients with portal hypertension and liver cirrhosis.We performed HALS first, thenconvertedtototallylarparocopicpericardialdevascularizationduring operation.ResultsAll patients received modified HALS plus pericardial devascularization without convertion to open surgery,the mean operative time was ( 154 ± 32) min,the mean intraoperative blood loss was ( 115 ±73) ml,and the mean postoperative hospitalization was (9.2 ± 1.6) days.The perioperative complications included plural effusion in 3 cases,ascites in 4 cases,pancreatic leakage in 1 case and wound dehiscence in 1case. Therewasnoperioperativemortality.ConclusionsModifiedHALSpluspericardial devascularization is a relatively safe and effective procedure in the treatment of portal hypertension due to liver cirrhosis,it has the advantage of hand-assisted and totally laparoscopic procedures.