Comparation of laparoscopic splenectomy for regional portal hypertension using the anterior versus the posterolateral approach

Abstract

Objective To study the anterior versus the posterolateral approach for laparoscopic splenectomy for patients with chronic pancreatitis-induced regional portal hypertension (PRPH). Methods The retrospective cohort study was carried out on 62 patients who underwent laparoscopic splenectomy for PRPH at the People's Hospital of Zhengzhou University from Jan 2010 to Jun 2016. The patients were divided into 2 groups: the anterior approach group and the posterolateral approach group, and to compare the differences. Results The operation time, amounts of intraoperative non-splenic blood loss, duration of recovery of intestinal peristalsis, duration of drainage, and duration of postoperative hospital stay were (135.0±12.8) min vs (126.0±13.1) min, (323.7±50.9) ml vs (245.1±35.0) ml, (25.5±2.5) h vs (23.5±3.3) h, (5.7±1.0) d vs (3.2±1.3) d and (9.3±1.5) d vs (7.3±1.2) d in the anterior approach laparoscopic splenectomy group versus the posterolateral approach laparoscopic splenectomy group. These differences were significantly different (all P<0.05). On follow-up of the 62 patients, improvements in the varicose veins of the lower esophagus and fundus of stomach at 3 month postoperatively were observed. All these patients recovered well from surgery. Conclusion The posterolateral approach laparoscopic splenectomy approach significantly improved the treatment results in patients with chronic pancreatitis-induced regional portal hypertension. Key words: Portal hypertension, regional; Laparoscopic splenectomy; Posterolateral approach; Chronic pancreatitis