title: Therapeutic effects of laparoscopic splenectomy and esophagogastric devascularization on liver cirrhosis and portal hypertension in 204 cases.
abstract: OBJECTIVE
  To investigate the effects and technical points of laparoscopic splenectomy and esophagogastric devascularization (LS+ED) for portal hypertension (PH) due to liver cirrhosis.
  
  
  METHODS
  In total, 204 PH patients who underwent LS+ED from January 2008 to April 2013 in the Southwest Hospital of the Third Military Medical University were enrolled in this study. We retrospectively analyzed the clinical data and the key technical points and compared the results with other researchers.
  
  
  RESULTS
  LS+ED was successfully carried out on 188 patients. The mean duration of surgery was 232±59 minutes, the mean intraoperative blood loss was 189±137 mL, the rate of blood transfusion was 19.6% (40/204), and no deaths occurred during surgery. The mean postoperative interval to passing of flatus was 3.5±0.9 days, and the mean postoperative hospital stay was 8.7±2.2 days. Operative complications occurred in 100 patients, of whom 78 had portal vein system thrombosis (PVST). During a postoperative follow-up period of 2-65 months, 15 cases were lost to follow-up, esophagogastric variceal bleeding re-occurred in 7 patients, encephalopathy occurred in 2 patients, and secondary liver cancer occurred in 3 patients. Five patients died during this period.
  
  
  CONCLUSIONS
  The technical points of LS+ED include a combined surgical approach, a reasonable surgical procedure, and an appropriate laparoscopic operating plane. LS+ED is a safe and effective treatment for minimal trauma and rapid recovery. PVST is a common and potentially life-threatening complication after LS+ED, and anticoagulation therapy should be given early.
authors: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University , Shapingba District, Chongqing, China .
authors: Zhe
authors: Z
authors: Cheng
authors: Jian-wei
authors: JW
authors: Li
authors: Jian
authors: J
authors: Chen
authors: Yu-dong
authors: YD
authors: Fan
authors: Peng
authors: P
authors: Guo
authors: Shu-guo
authors: SG
authors: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D001401:Azygos Vein / Q000601:surgery*; D016063:Blood Loss, Surgical; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000601:surgery; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000601:surgery*; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011169:Portal Vein / Q000601:surgery*; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult