title: Laparoscopic splenectomy is an effective and safe intervention for hypersplenism secondary to liver cirrhosis.
abstract: BACKGROUND
  Laparoscopic splenectomy has become the standard procedure for the normal to moderately enlarged spleens. We performed this study to investigate the safety, feasibility, and effectiveness of laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis.
  
  
  METHODS
  We performed a retrospective chart review of 24 cases of laparoscopic splenectomy (group 1), 24 cases of open splenectomy (group 2) for hypersplenism secondary to liver cirrhosis, and 68 cases of laparoscopic splenectomy for immune thrombocytopenic purpura (group 3). We performed comparisons between groups 1 and 2 and groups 1 and 3 in terms of demographic, intraoperative, postoperative variables, and changes in blood counts and liver function.
  
  
  RESULTS
  Patients in groups 1 and 2 had comparable demographic characteristics, but those in group 1 had less estimated blood loss, fewer complications, and shorter duration of oral intake, and they required less analgesia and shorter post-hospital stays. In both groups, leukocyte and platelet counts increased significantly and transaminase and total bilirubin decreased postoperatively, but not significantly, and there was no significant difference between the two groups. Compared with group 3, patients in group 1 were older, had lower preoperative hemoglobin levels and leukocyte counts, poorer Child-Pugh class, required more operation time, and suffered more estimated blood loss; however, there were no statistically significant differences in terms of conversion rates, transfusion rates, complication rates, and postoperative course.
  
  
  CONCLUSIONS
  Laparoscopic splenectomy is a safe, feasible, and effective procedure for hypersplenism secondary to liver cirrhosis.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yun Qiang
authors.initials: YQ
authors.lastname: Cai
authors.forename: Jin
authors.initials: J
authors.lastname: Zhou
authors.forename: Xiao Dong
authors.initials: XD
authors.lastname: Chen
authors.forename: Yi Chao
authors.initials: YC
authors.lastname: Wang
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wu
authors.forename: Bing
authors.initials: B
authors.lastname: Peng
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000191:economics / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications* / Q000191:economics; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D012189:Retrospective Studies; D013156:Splenectomy / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome