Short-term clinical outcome of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension in liver cirrhosis

doi:10.16139/j.1007-9610.2021.03.009

Abstract

Abstract:

Objective To investigate the short-term outcome and safety of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension. Methods A retrospective analysis was done with clinical data of 23 patients who underwent laparoscopic splenectomy combined with peripheral cardia disconnection in our hospital from September 2018 to December 2020. Comparison was performed using the clinical data of 13 cases with the method of open surgery, which were comparable to the clinical pathological baseline. Results Less blood loss, longer operative time, and earlier both exhaust time and feeding time were found in the patients of laparoscopic group compared with those in open group. There were no statistically significant differences in postoperative hospital stay and postoperative complications including bleeding, pleural effusion, deep vein thrombosis, gastroparesis, and incision infection between two groups(P>0.05). Conclusions Laparoscopic splenectomy combined with peripheral cardia disconnection can treat portal hypertension which is safe, less blood loss, early postoperative feeding and the short-term outcome similar to open surgery.

Key words: Laparoscopic, Splenectomy, Portal hypertension, Short-term outcome

CLC Number:

R657.34

CUI Ran, YE Lunhe, WANG Xujing, WANG Yongkun, ZHANG Qiqi, WANG Kaijing, WANG Ming, DAI Chenxin, YANG Ludi, DONG Chunxiu, CHEN Bo. Short-term clinical outcome of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension in liver cirrhosis[J]. Journal of Surgery Concepts & Practice, 2021, 26(03): 221-225.

Figures/Tables 4

References 12

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项目	腹腔镜组（n=23）	开腹组（n=13）	统计学值	P值
年龄（岁）	57.08±8.85	59.08±8.41	t=0.635	0.537
性别			χ²=1.541	0.214
男	11	9
女	12	4
身高（cm）	164.92±4.79	165.92±6.09	t=-0.41	0.689
体重（kg）	60.87±6.93	64.72±9.27	t=-1.001	0.337
BMI（kg/m²）	22.36±2.14	23.45±2.67	t=-1.043	0.318
肝功能Child-Pugh评分			χ²=0.171	0.679
A级	19	10
B级	4	3
EVB史			χ²=0.091	0.763
有	17	9
无	6	4
术前血红蛋白（g/L）	98.85±7.31	96.08±6.70	t=0.981	0.346
术前白细胞（×10⁹）	2.73±1.03	2.58±0.74	t=0.404	0.693
食管胃底静脉曲张程度			χ²=2.355	0.308
轻	1	0
中	10	3
重	12	10

项目	腹腔镜组 (n=23)	开腹组 (n=13)	统计学值	P值
手术时间（min）	181.54±51.13	120.54±41.48	t=3.581	<0.01
术中出血量（mL）	253.85±185.36	396.15±147.85	t=-2.467	0.03
术后排气时间（d）	3.31±0.75	4.77±1.17	t=-3.962	<0.01
进食流质时间（d）	3.62±1.04	5.00±1.47	t=-2.920	<0.01
术后住院时间（d）	11.31±1.65	12.46±2.76	t=-1.594	0.14
留置导尿管时间（d）	5.08±2.33	5.38±2.50	t=-0.368	0.72
术后并发症（n）			χ²=0.086	0.77
出血	1	0
胸腔积液	3	2
深静脉血栓	1	0
胃瘫	1	1
切口感染	0	2

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