Clinical experience of laparoscopic splenectomy and pericardial devascularization on the treatment of portal hypertension / 中华普通外科杂志

ABSTRACT

Objective To investigate the operational technique of laparoscopic splenectomy and pericardial devascularization (LSPD) and evaluate the clinical efficiency of this method for the treatment of portal hypertension.Methods With the new understanding of anatomical space around the spleen,the cardia and the fundus,two gaps and two tunnels can be created in LSPD.Retrospective analysis was made on the clinical data of patients who underwent LSPD from Jun 2013 to Mar 2015.The operative time,intraoperative blood loss,postoperative hospital stay,conversion rate and postoperative complication rate were measured.Results A total of 189 cases underwent surgery successfully,including 34 cases of splenomegaly and 21 cases of severe esophageal varices.The operative time was (125 ± 52) min,intraoperative blood loss (58 ± 32) ml,postoperative hospital stay (7.5-2.1) d.There were 4 conversion cases in this study.Conclusions The splenic pedicle and stomach pedicle can be safely dissected with the two gaps and two tunnels principle,which makes LSPD safe and convenient.