Laparoscopic splenectomy via spleen bed in combination with esophagogastric devascularization for the treatment of portal hypertension / 中华普通外科杂志

ABSTRACT

Objective To evaluate the feasibility and safety of laparoscopic splenectomy and esophagogastric devascularization (LSPD) via spleen bed using endoscopic linear stapler (Echelon Flex 60 Endopath) versus open splenectomy and esophagogastric devascularization (OSPD) for cirrhotic portal hypertension.Methods A total of 390 patients suffering from liver cirrhosis and portal hypertension operated in our department from Jun 2012 to Jul 2016 were divided into two groups145 for LSPD and 245 for OSPD.Characteristics,clinical data and postoperative complications were compared.Results There were no significant differences in estimated intraoperative blood loss between LSPD and OSPD groups.The operation time of LSPD group was longer than OSPD group.However,the time of hospital stay and time of oral intake were shorter in the LSPD group than the OSPD group (P ＜ 0.05).No significant differences were detected for liver function such as ALT,AST,T-BIL and ALB after operation,nor in the rate of postoperative complications between the 2 groups such as portal vein thrombosis,pancreatic leakage,pleural effusion and PLT ＞800 x 109/L.But amount of ascites and fever (＞38.0 ℃,＞3 d) in OSPD group was higher than LSPD group (P ＜ 0.05).Conclusions LSPD via spleen bed combined with endoscopic linear stapler for liver cirrhosis and portal hypertension is a safe and feasible procedure.