Department of Hepatobiliary Surgery, The First Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Dig Surg. 2009 Feb;26(6):499-505. doi: 10.1159/000236033. Epub 2010 Jan 14.
BACKGROUND/AIM: Total laparoscopic splenectomy (LS) + esophagogastric devascularization (ED) has been accepted as a safe treatment for patients with portal hypertension and serious gastroesophageal varices in China. This study was carried out to determine whether total LS + ED is more advantageous than the open procedure in the management of portal hypertension.
From February 2007 to July 2008, 24 patients were diagnosed with portal hypertension and serious gastroesophageal varices in our center. Seven patients underwent total LS + ED and 17 patients received the open procedure. Results and outcomes were compared retrospectively.
All operations were performed successfully. The operative time was similar in both groups (p = 0.355 > 0.05). The intraoperative blood loss was obviously less in the laparoscopic group (p = 0.001 < 0.05). Postoperative hospital stay was not different among the groups (p = 0.079 > 0.05), but this was mainly due to one complicated case in the laparoscopic group.
Although LS + ED entails meticulous technical preparation, it has the advantage of minimally invasive surgery and offers a good alternative for the management of portal hypertension.
背景/目的：全腹腔镜脾切除术（LS）+食管胃底血管离断术（ED）已被接受为中国门静脉高压症伴严重胃食管静脉曲张患者的安全治疗方法。本研究旨在确定全 LS+ED 是否比开放手术更有利于门静脉高压症的治疗。
2007 年 2 月至 2008 年 7 月，我院收治 24 例门静脉高压症伴严重胃食管静脉曲张患者。7 例行全 LS+ED，17 例行开放手术。回顾性比较结果和结局。
所有手术均成功完成。两组手术时间相似（p=0.355>0.05）。腹腔镜组术中出血量明显较少（p=0.001<0.05）。术后住院时间各组无差异（p=0.079>0.05），但这主要是由于腹腔镜组有 1 例复杂病例。
虽然 LS+ED 需要精细的技术准备，但它具有微创外科的优势，为门静脉高压症的治疗提供了良好的选择。
