Total laparoscopic versus open splenectomy and esophagogastric devascularization in the management of portal hypertension: a comparative study.
OBJECTIVE
Total laparoscopic splenectomy (LS) + esophagogastric devascularization (ED) has been accepted as a safe treatment for patients with portal hypertension and serious gastroesophageal varices in China. This study was carried out to determine whether total LS + ED is more advantageous than the open procedure in the management of portal hypertension.


METHODS
From February 2007 to July 2008, 24 patients were diagnosed with portal hypertension and serious gastroesophageal varices in our center. Seven patients underwent total LS + ED and 17 patients received the open procedure. Results and outcomes were compared retrospectively.


RESULTS
All operations were performed successfully. The operative time was similar in both groups (p = 0.355 > 0.05). The intraoperative blood loss was obviously less in the laparoscopic group (p = 0.001 < 0.05). Postoperative hospital stay was not different among the groups (p = 0.079 > 0.05), but this was mainly due to one complicated case in the laparoscopic group.


CONCLUSIONS
Although LS + ED entails meticulous technical preparation, it has the advantage of minimally invasive surgery and offers a good alternative for the management of portal hypertension.
Xin
Zheng
Z
Department of Hepatobiliary Surgery, The First Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China. paulzheng@stu.xjtu.edu.cn
Qingguang
Liu
L
Yingmin
Yao
Y
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures