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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2015, Vol. 04 ›› Issue (03): 154-156. doi: 10.3877/cma.j.issn.2095-3232.2015.03.005

Special Issue:

• Clinical Researches • Previous Articles     Next Articles

Laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhosis-induced portal hypertension

Xinhua Zhong1, Yuan Liu2, Bo Liu3, Kunpeng Hu3,()   

  1. 1. Outpatient Office, Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510530, China
    2. Nursing Department, Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510530, China
    3. Department of General Surgery, Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510530, China
  • Received:2015-02-02 Online:2015-06-10 Published:2015-06-10
  • Contact: Kunpeng Hu
  • About author:
    Corresponding author: Hu Kunpeng, Email:

Abstract:

Objective

To investigate the safety and application value of laparoscopic splenectomy combined with pericardial devascularization (devascularization) in the treatment of cirrhosis-induced portal hypertension.

Methods

Clinical data of 32 patients with cirrhosis and portal hypertension undergoing laparoscopic devascularization in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University from November 2011 to November 2013 were retrospectively studied. Among the 32 patients, 26 were males and 6 were females with the age ranging from 40 to 69 years old and the median of 53 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients received laparoscopic devascularization under intratracheal intubation anesthesia combined with intravenous anesthesia. One week before surgery, the patients were instructed to quit smoking and drinking, and received respiratory function training and in-bed toilet training. Vital signs were closely monitored and drainage volume was observed after surgery.

Results

All patients received larparoscopic devascularization successfully, with the average operation time of (110±15) min, intraoperative blood loss of (200±52) ml and length of hospital stay of (7±2) d. The blood coagulation and color Doppler ultrasound of portal vein were regularly followed up within 3 months after surgery. Seven cases suffered portal vein thrombosis after surgery and recovered after adjusting the anti-platelet and anti-coagulation therapy according to the situation of platelets and thrombus. No death, massive hemorrhage, digestive tract fistula and infection occurred during perioperative period.

Conclusions

Laparoscopic devascularization in the treatment of cirrhosis-induced portal hypertension is safe and effective. The rigorous perioperative management guarantees the safety of surgery.

Key words: Hypertension, porta, Splenomegaly, Splenectomy, Laparoscopes

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