Application of laparoscopic splenectomy in patients with HBV-related cirrhotic portal hypertension and splenomegaly

Abstract

Objective To investigate the safety and efficacy of laparoscopic splenectomy (LS) in patients with hepatitis B virus (HBV)-related cirrhotic, portal hypertension and splenomegaly. Methods Clinical data of 10 patients with HBV-related cirrhotic, portal hypertension and splenomegaly undergoing LS in 105th 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. Results 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. Conclusion LS is safe and effective for patients with HBV-related cirrhotic, portal hypertension and splenomegaly. Key words: Liver cirrhosis; Hypertension, portal; Laparoscopes; Splenectomy; Splenomegaly