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Postoperative outcomes after open splenectomy versus laparoscopic splenectomy in cirrhotic patients:a meta-analysis

Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 14-20页

作者： Khaled Al-raimi Shu-Sen Zheng Division of Hepatobiliary Pancreatic Surgery First Affiliated HospitalZhejiang University School of Medicine

BACKGROUND： Laparoscopic splenectomy is considered the gold standard for resecting normal-to-moderately bigger spleens in benign conditions, and in addition could be tried for patients with malignant splenic disorders. However, the safety of laparoscopic splenectomy in patients with hyper- splenism is not well-known. This study aimed to investigate the efficacy and safety of laparoscopic splenectomy for pa- tients with hypersplenism secondary to liver cirrhosis by com- paring with the open splenectomy.

关键词： open splenectomy laparoscopic splenectomy cirrhosis

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Clinical efficacy of total laparoscopic splenectomy for portal hypertension and its influence on hepatic hemodynamics and liver function

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World Journal of Gastrointestinal Surgery 2023年第8期15卷 1684-1692页

作者： Rui-Zhao Qi Zhi-Wei Li Zheng-Yao Chang Wei-Hua Chang Wen-Lei Zhao Chuan Pang Ying Zhang Xing-Long Hu Feng Liang Department of General Surgery 5th Medical CenterChinese PLA General HospitalBeijing 100039China Department of Hepatobiliary The 3rd People’s Hospital of ShenzhenShenzhen 518112Guangdong ProvinceChina

BACKGROUND The liver hemodynamic changes caused by portal hypertension(PH)are closely related to various complications such as gastroesophageal varices and portosystemic shunts,which may lead to adverse clinical outcomes in these patients,so it is of great clinical significance to find treatment strategies with favorable clinical efficacy and low risk of *** To study the clinical efficacy of total laparoscopic splenectomy(TLS)for PH and its influence on hepatic hemodynamics and liver *** Among the 199 PH patients selected from October 2016 to October 2020,100 patients[observation group(OG)]were treated with TLS,while the remaining 99[reference group(RG)]were treated with open splenectomy(OS).We observed and compared the clinical efficacy,operation indexes[operative time(OT)and intraoperative bleeding volume],safety(intraperitoneal hemorrhage,ascitic fluid infection,eating disorders,liver insufficiency,and perioperative death),hepatic hemodynamics(diameter,velocity,and flow volume of the portal vein system),and liver function[serum alanine aminotransferase(ALT),serum aspartate aminotransferase(AST),and serum total bilirubin(TBil)]of the two *** The OT was significantly longer and intraoperative bleeding volume was significantly lesser in the OG than in the ***,the overall response rate,postoperative complications rate,and liver function indexes(ALT,AST,and TBil)did not differ significantly between the OG and *** hepatic hemodynamics statistics showed that the pre-and postoperative blood vessel diameters in the two cohorts did not differ *** the postoperative blood velocity and flow volume reduced significantly when compared with the preoperative values,there were no significant inter-group *** TLS contributes to comparable clinical efficacy,safety,hepatic hemodynamics,and liver function as those of OS in treating PH,with a longer OT but lesser intraoperative blood loss.

关键词： Total laparoscopic splenectomy open splenectomy Portal hypertension Clinical efficacy Hepatic hemodynamics and liver function

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