Laparoscopic versus open splenectomy plus portaazygous devascularization in the treatment of patients with portal hypertension with recurrent upper gastrointestinal bleeding

Abstract

Objective To compare the efficacies of laparoscopic versus open splenectomy plus portaazygous devascularization in the treatment of patients with portal hypertension with recurrent upper gastrointestinal bleeding. Methods The clinical data of patients who underwent laparoscopic (n=60) versus open (n=52) splenectomy plus open portaazygous devascularization in the Department of Hepatobiliary Surgery, the Center Hospital of Xianyang City, Xi'an Jiaotong University Health Science Center from March 2014 to February 2017 were retrospectively analyzed. Results There was no perioperative death in the 2 groups. The amounts of intraoperative bleeding, the durations of the operation, the time of first flatus passed after operation and the duration of postoperative hospitalization were compared, and the differences were significantly different (t=3.288, 2.533, 3.325, 2.823, P 0.05). The incidence of postoperative complications was significantly higher in the open surgery group (χ2=7.622, P 0.05). On gastroscopy, the esophageal and gastric varices were significantly improved, and there was no significant difference between the two groups (χ2=0.718, P>0.05). Liver function was better in the laparoscopic group than the open group (χ2=3.765, P 0.05) were not significantly different. Conclusion Compared with laparotomy, laparoscopic splenectomy plus portaazygous devascularization had the advantages of less trauma, better short-term and long-term efficacies. Key words: Portal hypertension; Recurrent bleeding; Splenectomy; Portaazygous devascula-rization; Laparoscopic surgery; Surgical treatment