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- Title
Laparoscopic selective esophagogastric devascularization and splenectomy for patients with cirrhotic portal hypertension.
- Authors
Jie Lin; Qingbo Liu; Zhiqiang Liang; Wei He; Jianping Chen; Jing Ma; Chichang Gu; Weidong Wang
- Abstract
Introduction: The role of laparoscopic selective esophagogastric devascularization and splenectomy (LSEGDS) in the treatment of esophagogastric variceal bleeding and hypersplenism in patients with cirrhotic portal hypertension has not been well studied. Aim: To investigate the safety and efficacy of LSEGDS for esophagogastric variceal bleeding and hypersplenism in patients with cirrhotic portal hypertension. Material and methods: From May 2011 to December 2014, 74 patients with portal hypertension resulting from liver cirrhosis underwent surgery for gastroesophageal variceal bleeding and hypersplenism. Forty-one of these patients underwent laparoscopic esophagogastric devascularization and splenectomy (LEGDS), and the others underwent LSEGDS. A retrospective comparative analysis of clinical data was conducted between the two groups, including clinical characteristics, laboratory data, operative morbidity and mortality, and outcomes of follow-up. Results: The operation was completed successfully in all the patients, except that conversion was required in one patient in the LEGDS group. The operating time was similar in both groups (p = 0.579). The intraoperative blood loss was lower in the LSEGDS group (p = 0.011). Postoperative complications showed no significant difference between the two groups regarding mortality rate, pleural effusion, pancreatic injury, pulmonary infection, liver dysfunction, or postoperative abdominal bleeding. Postoperative platelet counts increased significantly more in the LEGDS group than in the LSEGDS group (p = 0.004). There were no significant differences in the long-term follow-up data, such as incidence of rebleeding, portal vein thrombosis, hepatic encephalopathy and survival (p > 0.05). Conclusions: The LSEGDS is a safe and effective procedure for management of cirrhotic portal hypertension, especially in patients with visible paraesophageal veins.
- Subjects
PORTAL hypertension; SPLENECTOMY; LUNG infections; THERAPEUTICS; CIRRHOSIS of the liver; HEPATIC encephalopathy
- Publication
Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i Inne Techniki Mało Inwazyjne, 2019, Vol 14, Issue 2, p187
- ISSN
1895-4588
- Publication type
Article
- DOI
10.5114/wiitm.2018.80297