title: Individualized Laparoscopic Therapy for Portal Hypertension: A Preliminary Single Center Experience.
abstract: BACKGROUND
  To investigate the effects and technical points of several individualized laparoscopic therapies for patients suffering from cirrhotic portal hypertension.
  
  
  METHODS
  In total, 385 cirrhotic patients who underwent the treatment of individualized laparoscopic therapy from February 2012 to December 2015 at the Clinical Medical College of Yangzhou University were enrolled in this study. We retrospectively analyzed the clinical data and the key technical points.
  
  
  RESULTS
  Individualized laparoscopic therapies were successfully performed on 379 of 385 cases. Six cases were converted to a laparotomy (the rate of conversion to laparotomy was 1.6%). Modified laparoscopic splenectomy (MLS) for cirrhotic patients with hypersplenism was successfully performed on 103 of 105 cases. Laparoscopic azygoportal disconnection for cirrhotic patients with esophagogastric variceal bleeding (EGVB) or F3 varices was successfully performed on 61 of 62 cases, and modified laparoscopic splenectomy and azygoportal disconnection (MLSD) for cirrhotic patients with hypersplenism and EGVB or F3 varices was successfully performed on 196 of 201 cases. Synchronous MLS and laparoscopic partial hepatectomy (SLSH) for cirrhotic patients with hypersplenism and hepatocellular carcinoma (HCC) and synchronous MLSD and laparoscopic partial hepatectomy (SLSDH) for cirrhotic patients with hypersplenism, EGVB or F3 varices and HCC were all successfully implemented on 12 and 5 patients, respectively. From May 2013, we used the intraoperative autologous cell salvage during each individualized laparoscopic procedure.
  
  
  CONCLUSIONS
  An individualized laparoscopic therapy was beneficial for different state of selected cirrhotic patients with portal hypertension with or without HCC.
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Dou-Sheng
authors.initials: DS
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Kui-Sheng
authors.initials: KS
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Jiang
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Qian
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Jin
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; 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; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods; D016896:Treatment Outcome
keywords: azygoportal disconnection; hepatectomy; laparoscopy; portal hypertension; splenectomy