Clinical effect of laparoscopic splenectomy combined with esophagogastric devascularization in treatment of liver cirrhosis with portal hypertension

Objective To investigate the effect and safety of laparoscopic splenectomy( LS) combined with esophagogastric devascularization( ED) in the treatment of esophagogastric variceal bleeding and severe hypersplenism. Methods A retrospective analysis was performed for 68 patients with cirrhotic portal hypertension who visited The Central Hospital of Hanzhong from June 2012 to June 2013. The patients were divided into LS + ED group and open splenectomy( OS) + ED group,with 34 patients in each group. The clinical indices,complications,degree of gastric varices before and after surgery,and changes in Child- Pugh score for liver function were compared between the two groups. The t- test was used for comparison of continuous data between groups,and the chi- square test or the Fisher's exact test was used for comparison of categorical data between groups. Results The LS + ED group had a significantly lower postoperative drainage volume,significantly less intraoperative blood loss,a significantly shorter length of postoperative hospital stay,and a significantly shorter postoperative ventilation time than the OS + ED group( t =- 3. 144,- 2. 536,- 4. 151,and- 2. 671,P = 0. 003,0. 015,0. 001,and 0. 002),while the improvements in the degree of gastric varices and Child- Pugh score for liver function showed no significant differences between the two groups( both P > 0. 05). Conclusion LS combined with ED can significantly reduce intraoperative blood loss,postoperative drainage volume,time of passage of gas by anus after surgery,and length of postoperative hospital stay,and therefore,it is a safe,feasible,and effective method for the treatment of portal hypertension.