探讨乙型病毒性肝炎（乙肝）后肝硬化门静脉高压症脾肿大患者腹腔镜脾切除术（LS）的安全性和疗效。

回顾性分析2008年9月至2014年12月中国人民解放军第105医院行LS的10例乙肝后肝硬化门静脉高压症脾肿大患者临床资料。其中男4例，女6例；年龄28～65岁，中位年龄48岁。轻度脾肿大1例，中度脾肿大9例。患者均签署知情同意书，符合医学伦理学规定。所有患者均采用传统四孔法行LS，观察围手术期情况及并发症发生情况。

10例患者均顺利完成LS，7例行单纯LS，2例行LS+胆囊切除术，1例行LS+门奇断流术。手术时间245（180～325）min，术中出血量200（20～800）ml，术中输血率5/10，并发症发生率8/10。1例术后死于弥散性血管内凝血，其余均康复出院。

LS治疗乙肝后肝硬化门静脉高压症脾肿大患者安全、有效。

To investigate the safety and efficacy of laparoscopic splenectomy (LS) in patients with hepatitis B virus (HBV)-related cirrhotic, portal hypertension and splenomegaly.

Clinical data of 10 patients with HBV-related cirrhotic, portal hypertension and splenomegaly undergoing LS in 105^th Hospital of Chinese People's Liberation Army between September 2008 and December 2014 were retrospectively analyzed. Among the patients, 4 were males and 6 were females, with the age ranging from 28 to 65 years old and the median of 48 years old. One case was with mild splenomegaly and 9 were with moderate splenomegaly. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients received conventional LS by 4-port approach. The perioperative conditions and complications were observed.

LS was successfully performed on all the patients. Seven cases underwent simple LS, 2 underwent LS + cholecystectomy, and 1 underwent LS + portal-azygous disconnection. The operation duration was 245 (180-325) min, the intraoperative blood loss was 200 (20-800) ml, the intraoperation blood transfusion rate was 5/10 and the incidence of complications was 8/10. One case died of disseminated intravascular coagulation, and other patients discharged after recovery.

LS is safe and effective for patients with HBV-related cirrhotic, portal hypertension and splenomegaly.