Abstract: Objective
To investigate the safety and short term efficacy of modified laparoscopic and open splenectomy and pericardial devascularization for the treatment of cirrhotic portal hypertension.
Methods
The clinical data of 107 patients with cirrhotic portal hypertension who were admitted to the Clinical Medical College of Yangzhou University from January 2010 to February 2013 were retrospectively analyzed. Patients were divided into the modified laparoscopic group (37 patients) and the open group (70 patients). The intra and postoperative condition of the patients of the 2 groups were compared. The measurement data were analyzed using the t test or Mann Whitney U test, and the enumeration data were analyzed using the chi square test.
Results
The median operation time of the modified laparoscopic group was 210 minutes (range, 185 -200 ml), 2.5±0.9, (1.5±0.7)days, (2.4±1.0)days, (2.7±0.7)days, (10.5±2.2)days in the modified laparoscopic group, and 300 ml (range, 188 400 ml), 5.1±1.1, (2.8±0.6)days, (3.2±1.0)days, (5.9±0.9)days and (15.7±4.3)days in the open group, with significant difference between the 2 groups ( Z= -12.546,-9.834,-3.635,-18.780, -8.350, P <0.05). The number of patients who had postoperative complications in the modified =5.913, P <0.05).
Conclusions The procedure of modified laparoscopic splenectomy and pericardial devascularization for cirrhotic portal hypertension is safe, feasible and with good therapeutic effect. It has better short term clinical effect than open surgery.