title: Perioperative advantages of modified laparoscopic vs open splenectomy and azygoportal disconnection.
abstract: OBJECTIVE
  To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy or open splenectomy and azygoportal disconnection for portal hypertension.
  
  
  METHODS
  This study included 44 patients who underwent modified laparoscopic splenectomy and azygoportal disconnection (MLSD) and 71 who underwent open procedures for portal hypertension. Blood samples were collected before surgery and on days 1, 3, and 7 after surgery. Markers of liver and renal function, C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) were measured, and perioperative variables were compared between the two groups.
  
  
  RESULTS
  The modified laparoscopic group showed significantly better and faster recovery, better liver and renal function, and fewer complications than the open group. CRP, IL-6, and PCT concentrations on postoperative days 1, 3, and 7 were significantly lower in the modified laparoscopic group than in the open group.
  
  
  CONCLUSIONS
  MLSD was associated with lower inflammatory immune responses, less impairment of liver and renal function, and faster and better recovery.
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Jiang
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Qian
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yao
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Wang
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Jin
authors.affiliation: Guo-Qing Jiang, Ping Chen, Jian-Jun Qian, Jie Yao, Xiao-Dong Wang, Sheng-Jie Jin, Dou-Sheng Bai, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
authors.forename: Dou-Sheng
authors.initials: DS
authors.lastname: Bai
mesh_terms: D000328:Adult; D001401:Azygos Vein / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D018836:Inflammation Mediators / Q000097:blood; D007668:Kidney / Q000503:physiopathology; D010535:Laparoscopy / Q000009:adverse effects; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure; D011169:Portal Vein / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators
keywords: Azygoportal disconnection; Inflammatory response; Laparoscopy; Portal hypertension; Splenectomy
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