To evaluate the application value of the full-process management of minimally invasive surgery, primarily laparoscopic splenectomy combined with pericardial devascularization (devascularization), for portal hypertension.

Clinical data of 263 patients with cirrhosis complicated with portal hypertension undergoing devascularization in Tangdu Hospital Affiliated to Air Force Medical University from January 2009 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 159 patients were male and 104 female, aged 17-77 years with a median age of 46 years. According to different managements, all the patients were divided into the new mode group (n=129) and control group (n=134). In the new mode group, the full-process surgery management of laparoscopic devascularization was adopted. In the control group, traditional perioperative management of open devascularization was performed. Perioperative conditions and complications were observed between two groups. Perioperative conditions were statistically compared between two groups by rank-sum test or t test. The incidence of complications was compared by Chi-square test.

In the new mode group, intraoperative blood loss was 562(500) ml, significantly less than 1 405(900) ml in the control group (Z=-9.472, P<0.05); The indwelling time of drainage tube and length of postoperative hospital stay were (4.2±2.3) d and (7.7±3.0) d, significantly shorter than (6.3±2.7) d and (9.6±2.9) d in the control group (t=-6.778, -5.223; P<0.05). In the new mode group, the AST and TB levels at postoperative 3 d were 33(17) U/L and 24(13) μmol/L, significantly lower than 41(21) U/L and 40(22) μmol/L in the control group (Z=-2.708, -4.775; P<0.05); PT was (13.5±1.5) s, significantly shorter than (16.3±2.8) s in the control group (t=-8.594, P<0.05). The incidence of severe postoperative complications in the new mode group was 15%(19/129), significantly lower compared with 51%(68/134) in the control group (χ²=38.520, P<0.05).

The full-process management of minimally invasive surgery, mainly laparoscopic devascularization, is safe and efficacious for portal hypertension, which can guarantee the perioperative safety, reduce the risk of surgical complications and accelerate recovery of patients.