title: Laparoscopic gastric devascularization without splenectomy is effective for the treatment of gastric varices.
abstract: BACKGROUND
  Laparoscopic gastric devascularization of the upper stomach in patients with gastric varices has rarely been reported. Perioperative clinical data were compared with patients who underwent open surgery.
  
  
  METHODS
  From 2009 to 2012, we performed laparoscopic gastric devascularization without splenectomy for the treatment of gastric varices in eight patients. The patients included four males and four females. Peri-gastric vessels were divided using electrical coagulating devices or other devices according to the diameter of the vessels. Two patients underwent conversion to open surgery due to intraoperative bleeding.
  
  
  CONCLUSIONS
  Intraoperative blood loss in patients who accomplished laparoscopic devascularization was very small (mean 76ml). However, once bleeding occurs, there is a risk of causing massive bleeding.
  
  
  CONCLUSIONS
  With further improvement of laparoscopic devices, laparoscopic gastric devascularization without splenectomy must be an effective and less-invasive surgical procedure in the treatment of gastric varices.
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan. Electronic address: th-zuiki@jichi.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Zuiki
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hosoya
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Yasunaru
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Hyodo
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Lefor
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sata
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Medical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nagamine
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Medical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Isoda
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Medical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.affiliation: Jichi Medical University, Clinical Institute of Digestive Diseases, Surgical Branch, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
keywords: Devascularization; Gastric varices; Laparoscopy; Liver cirrhosis; Minimally invasive surgery; Splenectomy