[Laparoscopic splenectomy and pericardial devascularization for treatment of portal hypertension due to liver cirrhosis].
OBJECTIVE
To evaluate the safety and efficacy of laparoscopic splenectomy (LS) and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis.


METHODS
Twenty three cases with hepatitis B and schistosoma cirrhosis and portal hypertension underwent LS and paraesophagogastric devascularization performed by one treatment team. Follow-up was conducted for 9 months.


RESULTS
LS combined with pericardial devascularization was successfully performed on these 20 cases. Three cases were converted to open surgery due to intra-operative bleeding. The mean operative time was 235 min (180 - 350), and mean intra-operative blood loss was 520 ml (200 - 1600 ml). All patients were treated with plasma transfusion, antibiotics, and abdominal drainage post-operatively. Peristalsis of stomach and intestine recovered 24 - 72 hours after operation. The mean hospitalization time was 8.5 days (6 - 17 days). The peri-operative complication included plural effusion in 3 cases and subphrenic abscess in one case, .mild ascites in two cases, and wound dehiscence in one case. No mortality occurred. Rebleeding rare was 0%.


CONCLUSIONS
LS combined with pericardial devascularization is relatively safe and effective in treatment of portal hypertension due to liver cirrhosis. The keys to success include experienced laparoscopic skills, use of harmonic scalpel and careful manipulation.
Hong
De-fei
DF
Department of General Surgery, Sir Run Run Shaw Hospital, Medical college of Zhejiang University, Hangzhou 310016, China. hongdefi@mail.hz.zj.cn
Zheng
Xue-yong
XY
Peng
Shu-you
SY
Gao
Min
M
Wu
Jia-guo
JG
Cao
Qian
Q
D000328:Adult; D000368:Aged; D002299:Cardia / Q000098:blood supply; D003131:Combined Modality Therapy; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*