title: Laparoscopic splenectomy and esophagogastric devascularization is a safe, effective, minimally invasive alternative for the treatment of portal hypertension with refractory variceal bleeding.
abstract: Open splenectomy and esophagogastric devascularization (OSED) is a typical surgery for portal hypertension. Because of the high morbidity associated with it, it is desirable to develop a minimally invasive alternative. To investigate the safety and effect of laparoscopic splenectomy and esophagogastric devascularization (LSED), we performed LSED for 24 patients suffering from portal hypertension with refractory variceal bleeding while conducting OSED for 30 patients. The perioperative data and follow-up results were analyzed. Operation times were similar in both groups. Less intraoperative blood and faster return of gastrointestinal function were found in the LSED group. The LSED group had lower levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin after surgery. In both groups, the levels of platelet count, white blood cell count, or hemoglobin were increased after operation dramatically. During the follow-up period (range = 3-36 months), no patient had recurrent hypersplenism or variceal bleeding. Hence, LSED is a safe and minimally invasive intervention for portal hypertension with refractory variceal bleeding.
authors.affiliation: The First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zheng
authors.forename: Qingguang
authors.initials: Q
authors.lastname: Liu
authors.forename: Yingmin
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000032:analysis; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D007432:Intraoperative Period; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric
chemical_list: D000410:Alanine Transaminase