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Long-term postoperative outcomes of hypersplenism: laparoscopic versus open splenectomy secondary to liver cirrhosis

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Abstract

Background

Hypersplenism is a common clinical manifestation in patients with liver cirrhosis. For treatment, surgeons can choose between two options: open splenectomy (OS) or laparoscopic splenectomy (LS). Although splenectomy has wide exposure and acceptance as a remedy for the patients with hypersplenism secondary to liver cirrhosis, the data are sparse with regard to its long-term outcomes, including hematologic response and liver function after the surgery. This study aimed to determine the long-term effect of OS versus LS for cirrhotic patients with hypersplenism.

Methods

Between September 2003 and June 2011, the study enrolled 63 consecutive patients with hypersplenism secondary to liver cirrhosis who were treated with LS (n = 34) or OS (n = 29). The hematologic parameters and liver function in both groups were evaluated before and after splenectomy, and a comparative study of the long-term follow-up period was conducted.

Results

Postoperatively, 100 % of the patients in both groups had a complete response in terms of platelet and leukocyte counts. No changes in liver function were noted. The LS group benefited from less intraoperative blood loss and a shorter postoperative hospital stay than the OS group experienced. The mean follow-up period was 25 months. To date, no death has been reported in either group. All the patients showed complete or partial hematologic response to splenectomy and exhibited improvement in liver function. None of the parameters differed significantly between the two groups. Portal or splenic vein thromboses were detected in three patients (2 in OS and 1 in LS), whereas esophageal variceal bleeding occurred for one patient in the LS group and one patient in the OS group.

Conclusion

This study investigated patients with hypersplenism secondary to liver cirrhosis. The findings showed that LS can be considered a well-disposed surgical procedure with good surgical outcomes compared with OS.

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Acknowledgments

The study had a grant from the West China Hospital, Sichuan University.

Disclosures

Jin Zhou, Zhong Wu, Prasoon Pankaj, and Bing Peng have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China

    Jin Zhou

  2. Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China

    Zhong Wu, Prasoon Pankaj & Bing Peng

Authors
  1. Jin Zhou
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  2. Zhong Wu
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  3. Prasoon Pankaj
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  4. Bing Peng
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Corresponding author

Correspondence to Bing Peng.

Additional information

J. Zhou and Z. Wu contributed equally to this work.

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Zhou, J., Wu, Z., Pankaj, P. et al. Long-term postoperative outcomes of hypersplenism: laparoscopic versus open splenectomy secondary to liver cirrhosis. Surg Endosc 26, 3391–3400 (2012). https://doi.org/10.1007/s00464-012-2349-6

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  • DOI: https://doi.org/10.1007/s00464-012-2349-6

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