Retrospective Study Of Laparoscopic And Open Splenectomy Combined With Cardiac Peripheral Vascular Disconnection In The Treatment Of Portal Hypertension

BackgroundPortal hypertension is a common clinical syndrome,with high incidence,clinical go up more difficult and case fatality rate is high,because after portal vein obstruction and blood stasis cause portal vein blood flow to the system pressure is higher.The current main methods for the treatment of portal hypertension are drugs,endoscopy,intervention,surgery and liver transplantation.At present domestic mostly surgical treatment,and give priority to with cut-out operation,its main purpose is to prevent and control the stomach esophagus varicose vein rupture hemorrhage[1].With the development of laparoscopic minimally invasive technology and innovation of laparoscopic instruments laparoscopic minimally invasive technique has been more and more used in the treatment of portal hypertension,surgical way varied also.Traditional laparoscopic minimally invasive surgery and treatment of the treatment effect of the two treatments and prognosis of contrast,still need further clinical research.ObjectiveEvaluation of minimally invasive laparoscopic technique in particular is totally laparoscopic splenectomy and pericardial devascularization for treatment of portal hypertension feasibility and safety,to provide guidance for the application of minimally invasive laparoscopic surgery for portal hypertension clinic.MethodsA retrospective analysis from June 2012-2015 year in July admitted to the Henan Province People's Hospital for diagnosis of hepatobiliary and pancreatic surgery for portal hypertension with hypersplenism and esophageal varices,and clinical data of 290 cases of splenectomy plus pericardial devascularization in patients.The observation index data record two patients gender,age,operation time,intraoperative blood loss,postoperative liver function,postoperative eating time,hospitalization days and postoperative portal vein thrombosis,pancreatic leakage,pleural effusion,abdominal effusion and fever and other complications,and comparative analysis of laparoscopic splenectomy plus pericardial devascularization and open splenectomy plus pericardial devascularization clinical results,related complications and the corresponding treatment measures.Results1.Patients enrolled in 180 cases of male,female 110 cases,the application of laparoscopic splenectomy plus pericardial blood vessel surgery patients off treatment of 45 cases,the application of open splenectomy plus pericardial devascularization capacity of 245 cases.Two methods of operation can successfully complete the surgery,laparoscopic laparotomy was no case;2.The difference between the preoperative general information laparoscopic group and open group between the two groups was not statistically significant(P> 0.05);3.Laparoscopic group and open group contrast,longer operative time(P<0.01),less blood loss(P<0.01),after eating earlier(P<0.01),the total number of hospital days shorter(P<0.01),fewer complications,and the difference was statistically significant(P<0.05).ConclusionLaparoscopic splenectomy plus pericardial devascularization surgery takes longer than open surgery time,but with less blood loss,faster recovery of gastrointestinal function after surgery,shorter hospital stay,low complication rate,etc.for the treatment of liver cirrhosis and portal hypertension is effective and safe in clinical worth promoting.