title: Laparoscopic splenic vessels ligation as a treatment of hypersplenism and thrombocytopenia in children.
abstract: Splenectomy and partial splenic embolization as the surgical approach in the treatment of hypersplenism and thrombocytopenia have been reported. However, there are still some disadvantages in the application of these techniques. In this article, we propose a new technique for the treatment of hypersplenism and thrombocytopenia in children and report our preliminary experience.
  
  
  
  From Aug 2014 to Dec 2014, four children with hypersplenism and three children with idiopathic thrombocytopenic purpura were treated in our hospital. Laparoscopic splenic vessels ligation was performed in all patients. The gastric wall was suspended to expose the pancreatic tail and spleen, and the splenic artery was ligated at the superior border of the pancreas. The splenic venous branches were dissected and ligated at the splenic hilum using the Hem-o-lok.
  
  
  
  The laparoscopic splenic vessels ligation was successfully performed in all patients. The average operative time was 126 min (range 120-150 min). No patient required transfusion, and the length of hospital stay varied from 4 to 11 days (mean 6.6 days). The patients were followed up for 6-10 months (mean 8.5 months). The complete blood counts were within normal range. The size of spleen decreased postoperatively. The partial splenic infarction and the reduction in splenic blood flow were confirmed in all patients by postoperative ultrasound and CT.
  
  
  
  The laparoscopic splenic vessels ligation is a feasible option for treating hypersplenism and thrombocytopenia in children.
authors.affiliation: Department of General Surgery, Capital Institute of Pediatrics, No.2 Yabaolu Rd., Beijing, 100020, China.
authors.forename: Jin-Shan
authors.initials: JS
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Capital Institute of Pediatrics, No.2 Yabaolu Rd., Beijing, 100020, China. zjs851114@163.com.
authors.forename: Long
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of General Surgery, Capital Institute of Pediatrics, No.2 Yabaolu Rd., Beijing, 100020, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Surgery, Beijing United Family Hospital, Beijing, China.|Departments of Paediatrics and Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008026:Ligation; D008297:Male; D061646:Operative Time; D013157:Splenic Artery / Q000601:surgery*; D013162:Splenic Vein / Q000601:surgery*; D013921:Thrombocytopenia / Q000601:surgery*
keywords: Children; Hypersplenism; Laparoscopy; Splenic vessels ligation; Thrombocytopenia