title: Laparoscopic surgery is more advantageous than laparotomic surgery for treatment of hypersplenism with gallstones.
abstract: BACKGROUND
  The aim of this study was to compare laparoscopic vs. laparotomic surgery for the treatment of hypersplenism with gallstones.
  
  
  METHODS
  Forty patients were treated with splenectomy and cholecystectomy using either totally laparoscopic surgery (laparoscopic group) or laparotomy (laparotomy group). The outcomes were duration of the surgery, intraoperative bleeding volume, postoperative complications, and number of postoperative hospitalization days.
  
  
  RESULTS
  There was no difference in the duration of the surgery between both groups. No patient experienced intraoperative complications. There were postoperative pleural effusions (N.=3) and bleeding at the puncture site (N.=1) in laparoscopic group, and postoperative pleural effusions (N.=2), incision infection (N.=2) and peritoneal effusion (N.=1) in laparotomy group. The length of postoperative hospitalization was markedly shorter in laparoscopic group. The follow-up for 3 to 15 months after the surgery demonstrated that hypersplenism was corrected in all patients. All blood markers (white blood cells, platelets, and hemoglobin) recovered to normal levels. The portal vein thrombosis occurred in 6 patients of laparoscopic group and 5 patients of laparotomy group; this was controlled by oral administration of Warfarin and enteric coated Aspirin capsules.
  
  
  CONCLUSIONS
  Treatment efficacy is comparable between laparoscopic surgery and traditional laparotomy. Laparoscopic surgery is more advantageous because of smaller trauma, faster postoperative recovery, and minimal invasiveness.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Jinhua Guangfu Hospital, Jinhua, China - xusq0420@163.com.
authors.forename: Yifu
authors.initials: Y
authors.lastname: Wu
authors.forename: Yong
authors.initials: Y
authors.lastname: Qin
authors.forename: Shengqian
authors.initials: S
authors.lastname: Xu
authors.forename: Debiao
authors.initials: D
authors.lastname: Pan
authors.forename: Guanxiong
authors.initials: G
authors.lastname: Ye
authors.forename: Chengjun
authors.initials: C
authors.lastname: Wu
authors.forename: Shi
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D006971:Hypersplenism / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome