title: A novel method for laparoscopic splenectomy in the setting of hypersplenism secondary to liver cirrhosis: ten years' experience.
abstract: BACKGROUND
  It is a technical challenge to perform laparoscopic splenectomy (LS) on patients with liver cirrhosis. The purpose of this article is to share our experience with performing LS in the setting of hypersplenism secondary to liver cirrhosis.
  
  
  METHODS
  A total of 43 LSs for hypersplenism secondary to liver cirrhosis were performed between September 2003 and January 2013. The patients studied in this series were consecutively enrolled. All of the surgeries were performed by a single surgeon. We divided our patients into two groups based on whether splenogastric ligament-entranced laparoscopic splenectomy (SLELS) was used. Data were collected retrospectively by chart review.
  
  
  RESULTS
  The patients in the two groups had comparable demographic characteristics. Patients who underwent LS with SLELS (group 2) required less operating time (195.2 ± 45.8 vs. 227.7 ± 52.1 min, p = 0.042) and suffered less blood loss (160.4 ± 107.6 vs. 270.1 ± 231.2 ml, p = 0.031). No significant difference was found in terms of blood transfusion, conversion, postoperative hospital stay, and complications.
  
  
  CONCLUSIONS
  It is safe and feasible to perform LS on patients with hypersplenism secondary to liver cirrhosis. In the procedure of SLELS, we highlight the importance of sufficient elevation the upper pole of the spleen.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
authors.forename: Yunqiang
authors.initials: Y
authors.lastname: Cai
authors.forename: Xubao
authors.initials: X
authors.lastname: Liu
authors.forename: Bing
authors.initials: B
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D059032:Learning Curve; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome