From June 2006 to March 2009, laparoscopic
splenectomy and azygoportal disconnection (
LSD) were performed on 28 patients with
cirrhosis,
bleeding due to
portal hypertension, and secondary
hypersplenism. Success was achieved in 26 patients. Demographic, intraoperative, and postoperative variables of the patients were compared.
RESULTS: Success of laparoscopic
splenectomy and azygoportal disconnection was achieved in all but two patients (7.14%) who required open
splenectomy and azygoportal devascularization (OSD). The operation time was significantly longer in patients undergoing
LSD than in those undergoing OSD (235 +/- 36 min vs 178 +/- 47 min, P < 0.05). The estimated intraoperative blood loss was much more in patients receiving OSD than in those receiving
LSD (420 +/- 50 mL vs 200 +/- 30 mL, P < 0.01). The proportion of patients undergoing laparoscopic and open
splenectomy and azygoportal disconnection who received transfusion of packed red blood cells during or after the operation was 23.08% and 38.46%, respectively (P < 0.05). The time of first oral intake was faster in patients after
LSD than in those after OSD (1.5 +/- 0.7 d vs 3.5 +/- 1.6 d, P < 0.05). The
hospital stay of patients after
LSD was shorter than that of patients after OSD (6.5 +/- 2.3 d vs 11.7 +/- 4.5 d, P < 0.05). The
pain requiring medication was less severe in patients after
LSD than in those after OSD (7.69% vs 73.08%, P < 0.001). The overall complication rate was lower in patients after
LSD than in those after OSD (19.23% vs 42.31%, P < 0.05).
CONCLUSION: