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  • Title: Laparoscopic VS. Open splenectomy and oesophagogastric devascularisation for liver cirrhosis and portal hypertension: A retrospective cohort study.
    Author: Deng ZC, Jiang WZ, Chen L, Tang XD, Liu SH.
    Journal: Int J Surg; 2020 Aug; 80():79-83. PubMed ID: 32619623.
    Abstract:
    BACKGROUND: We compared laparoscopic splenectomy combined with oesophagogastric devascularisation vs. open splenectomy combined with oesophagogastric devascularisation in patients with portal hypertension secondary to liver cirrhosis. MATERIALS AND METHODS: This study included 192 patients diagnosed with portal hypertension and severe gastroesophageal varices at our hospital between January 2002 and December 2018; 62 patients underwent laparoscopic splenectomy combined with oesophagogastric devascularisation (laparoscopic group), and 130 patients underwent the open procedure (open group). The results and outcomes were compared retrospectively. RESULTS: The median blood loss was significantly less in the laparoscopic group than in the open group (180 vs. 380 mL, P < 0.001). The length of hospitalisation was shorter (6 vs. 11 days, P < 0.001) and the complication rate was lower in the laparoscopic group (P < 0.001). The general complication rates were 23.8% and 4.8% (P < 0.001), and the surgical complication rates were 56.1% and 24.2% (P < 0.001) in the open and laparoscopic groups, respectively. During a postoperative follow-up period of 10-60 months, the incidence of oesophagogastric variceal rebleeding showed no significant difference between groups. CONCLUSION: Laparoscopic splenectomy combined with oesophagogastric devascularisation is technically feasible and safe in selected patients. Compared with the open group, the laparoscopic group showed a less volume of blood loss, shorter length of hospitalisation, and fewer postoperative complications but similar long-term outcomes.
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