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Long-term postoperative outcomes of hypersplenism: laparoscopic versus open splenectomy secondary to liver cirrhosis.
MedLine Citation:
PMID:  22648114     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Jin Zhou; Zhong Wu; Prasoon Pankaj; Bing Peng
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-31
Journal Detail:
Title:  Surgical endoscopy     Volume:  -     ISSN:  1432-2218     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
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