Document Detail

Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review.
MedLine Citation:
PMID:  23170929     Owner:  NLM     Status:  Publisher    
BACKGROUND: Open splenectomy and devascularization are effective treatments for cirrhotic patients with severe thrombocytopenia and variceal bleeding. However, it remains controversial whether laparoscopic splenectomy (LS) and devascularization (LSD) can be indicated and beneficial in these patients. OBJECTIVES: A systematic review of the efficacy and safety of LS and LSD for patients with liver cirrhosis and portal hypertension was undertaken to clarify controversy about their utilization in such patients. METHODS: A systematic search strategy was performed to retrieve relevant studies from PubMed and The literature search and data extraction were independently performed by two reviewers. RESULTS: Sixteen articles met the inclusion criteria. The methodology of the identified articles was poor. Six hundred and fifty-one patients, including 478 LS patients and 173 LSD patients, were involved in efficacy and safety evaluations. There was wide variability in the outcome measures between studies. There was only one death in the patients underwent LSD. Reported major complications included post-operative bleeding requiring re-surgery, pancreatic leakage and gastric perforation. Seven studies were identified with comparisons between laparoscopic and open procedures. No meta-analysis was possible because of heterogeneity between studies and lack of randomization. CONCLUSIONS: The publications reviewed revealed LS and LSD to be safe and effective in the setting of liver cirrhosis and portal hypertension. From the comparison articles, laparoscopic procedures appear to be superior to open procedures regarding blood loss, hospital stay, complication rate and liver function impairment. However, it is difficult to draw firm statistical conclusions due to lack of high-quality evidence.
Xiao-Dong Chen; Fu-Qian He; Lie Yang; Yong-Yang Yu; Zong-Guang Zhou
Related Documents :
23763009 - Translocated intrauterine contraceptive device: experiences of two medical centers with...
23814299 - Laparoscopic-assisted cystotomy for urolith removal in dogs and cats - 23 cases.
23562899 - Subcutaneous emphysema of thorax, neck and face after elective left colectomy: a case r...
24743609 - A risk model for esophagectomy using data of 5354 patients included in a japanese natio...
15915209 - Surgical wafers: a comparative study.
24205909 - Subthalamotomy in the treatment of parkinson's disease: clinical aspects and mechanisms...
23992719 - Twisted wire stent technique for delayed sternal closure after congenital heart operati...
831349 - Transpubic urethroplasty for membranous urethral strictures.
3167819 - The management of vaginal melanoma.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-22
Journal Detail:
Title:  ANZ journal of surgery     Volume:  -     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Department of Hepatobiliary-Gastrointestinal Surgery, Sichuan Cancer Hospital and Institute, Chengdu, China; Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The role of the saturated non-esterified fatty acid palmitate in beta cell dysfunction.
Next Document:  The Effect of Docosahexaenoic Acid on t10, c12-Conjugated Linoleic Acid-Induced Changes in Fatty Aci...