title: Laparoscopic and Open Splenectomy and Hepatectomy.
abstract: OBJECTIVE
  Patients undergoing synchronous open splenectomy and hepatectomy (OSH) for concurrent hepatocellular carcinoma (HCC) and hypersplenism usually have major surgical trauma caused by the long abdominal incision. Surgical procedures that contribute to rapid recovery with the least possible impairment are desired by both surgeons and patients. The objective of this study was to explore outcomes in patients treated with simultaneous laparoscopic or open splenectomy and hepatectomy for hepatocellular carcinoma (HCC) with hypersplenism.
  
  
  METHODS
  We retrospectively evaluated the treatment outcomes in 23 patients with cirrhosis, HCC, and hypersplenism, who underwent simultaneous laparoscopic splenectomy and hepatectomy (LSH;n= 12) or open splenectomy and hepatectomy (OSH;n= 11) from January 2012 through December 2015. Their perioperative variables were compared.
  
  
  RESULTS
  LSH was successful in all patients. There were nonsignificant similarities between the 2 groups in duration of operation, estimated blood loss, and volume of blood transfused (P> .05 each). Compared with OSH, LSH had a significantly shorter postoperative visual analog scale pain score (P< .001); shorter time to first oral intake (P< .001), passage of flatus (P< .05) and off-bed activity (P< .001); shorter postoperative duration of hospitalization (P< .001); fewer days of postoperative temperature >38.0°C (P< .01); fewer postoperative complications (P< .05); and better liver and renal function on postoperative days 7 (P< .05 each).
  
  
  CONCLUSIONS
  Simultaneous LSH is safe for selected patients with HCC and hypersplenism associated with liver cirrhosis.
authors.affiliation: Department of Hepatobiliary Surgery, Jingjiang Hospital of Traditional Chinese Medicine, Jingjiang, Jiangsu, China.
authors.forename: Jing-Feng
authors.initials: JF
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
authors.forename: Dou-Sheng
authors.initials: DS
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Jiang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Jin
authors.affiliation: Department of Hepatobiliary Surgery, Jingjiang Hospital of Traditional Chinese Medicine, Jingjiang, Jiangsu, China.
authors.forename: Zhi-Xian
authors.initials: ZX
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hepatectomy; Hepatocellular carcinoma; Hypersplenism; Laparoscopy; Splenectomy