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Combined Laparoscopic Splenectomy and Esophagogastric Devascularization versus Open Splenectomy and Esophagogastric Devascularization for Portal Hypertension due to Liver Cirrhosis

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Summary

This study was conducted to compare the feasibility, safety and effectiveness of the combined-laparoscopic splenectomy and esophagogastric devascularization (C-LSED) with open splenectomy and esophagogastric devascularization surgery (OSED) in patients with portal hypertension due to liver cirrhosis. From February 2014 to June 2018, 68 patients with portal hypertension were diagnosed as having serious gastroesophageal varices and/or hypersplenism in our center. Thirty patients underwent C-LSED and 38 patients received OSED. Results and outcomes were compared retrospectively. No patients of C-LSED group required an intraoperative conversion to open surgery. Significantly shorter operating time, less blood loss, lower transfusion rates, shorter postoperative hospital stay, lower rates of complications were found in C-LSED group than in C-LSED group (P<0.05). No death and rebleeding were documented in both groups during the follow-up periods of one year. Postoperative endoscopy revealed that varices in the patients of both groups were alleviated significantly from severe to mild, and in a part of cases, the varices disappeared. The final results suggest that the C-LSED technique is superior to open procedure, due to slightly invasive, simplified operative procedure, significantly shorter operating time, less intraoperative bleeding and lower post-operative complication rates. And C-LSED offers comparable long-term effects to open surgery.

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Authors and Affiliations

  1. Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Hong-ping Luo, Zhan-guo Zhang, Xin Long, Fei-long Liu, Xiao-ping Chen, Lei Zhang & Wan-guang Zhang

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  1. Hong-ping Luo
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  2. Zhan-guo Zhang
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  3. Xin Long
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  4. Fei-long Liu
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  5. Xiao-ping Chen
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  6. Lei Zhang
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  7. Wan-guang Zhang
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Corresponding authors

Correspondence to Lei Zhang or Wan-guang Zhang.

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Conflict of Interest Statement

The authors declare no conflict of interest.

This work was supported by grants from Liver Surgery Medical Research Center Project in Hubei Province and China National Key Projects for Infectious Diseases (No. 2008ZX10002-025).

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Luo, Hp., Zhang, Zg., Long, X. et al. Combined Laparoscopic Splenectomy and Esophagogastric Devascularization versus Open Splenectomy and Esophagogastric Devascularization for Portal Hypertension due to Liver Cirrhosis. CURR MED SCI 40, 117–122 (2020). https://doi.org/10.1007/s11596-020-2154-8

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  • DOI: https://doi.org/10.1007/s11596-020-2154-8

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