Laparoscopic and open splenectomy and azygoportal disconnection for portal hypertension

作者：Xiaozhong Jiang, Shao-Yong Zhao, Hong Luo, Bin Huang, Changsong Wang, Lei Chen, Youjiang Tao · 发表于：World Journal of Gastroenterology · 年份：2009 · DOI：10.3748/wjg.15.3421 · 被引用次数：45 · 研究领域：Liver Disease and Transplantation、Abdominal Trauma and Injuries、Appendicitis Diagnosis and Management

AIM: To compare the outcomes of laparoscopic and open splenectomy and azygoportal devascularization for portal hypertension. METHODS: From June 2006 to March 2009, laparoscopic splenectomy and azygoportal disconnection (LSD) were performed on 28 patients with cirrhosis, bleeding due to portal hypertension, and secondary hypersplenism. Success was achieved in 26 patients. Demographic, intraoperative, and postoperative variables of the patients were compared. RESULTS: Success of laparoscopic splenectomy and azygoportal disconnection was achieved in all but two patients (7.14%) who required open splenectomy and azygoportal devascularization (OSD). The operation time was significantly longer in patients undergoing LSD than in those undergoing OSD (235 +/- 36 min vs 178 +/- 47 min, P < 0.05). The estimated intraoperative blood loss was much more in patients receiving OSD than in those receiving LSD (420 +/- 50 mL vs 200 +/- 30 mL, P < 0.01). The proportion of patients undergoing laparoscopic and open splenectomy and azygoportal disconnection who received transfusion of packed red blood cells during or after the operation was 23.08% and 38.46%, respectively (P < 0.05). The time of first oral intake was faster in patients after LSD than in those after OSD (1.5 +/- 0.7 d vs 3.5 +/- 1.6 d, P < 0.05). The hospital stay of patients after LSD was shorter than that of patients after OSD (6.5 +/- 2.3 d vs 11.7 +/- 4.5 d, P < 0.05). The pain requiring medication was less severe in patients ...