Spleen bed laparoscopic splenectomy plus pericardial devascularization for elderly patients with portal hypertension.

INTRODUCTION

Laparoscopy splenectomy has been a preferred choice over open surgery, but limited studies dealing with laparoscopy splenectomy plus pericardial devascularization (LSPD) for elderly patients are available.

AIM

To assess the safety and long-term efficacy of spleen bed LSPD for elderly patients with portal hypertension.

MATERIAL AND METHODS

A total of 132 elderly patients (age > 60 years) suffering from portal hypertension were operated on in the department. The patients were divided into 2 groups: those undergoing LSPD, and those undergoing open splenectomy plus pericardial devascularization (OSPD). Results and outcomes were compared retrospectively.

RESULTS

The clinical characteristics of the patients belonging to the two groups were studied. No significant difference between the characteristics of patients was reported and the clinical data revealed similarities in their characteristics. There was no significant difference in time taken for performing the operation (p > 0.05). The LSPD group showed less blood loss; started oral intake early; and the duration of post-operative hospital stay was also shorter (p < 0.05). Incidence rates of portal vein thrombosis; pancreatic leakage; pleural effusion; pulmonary infection; and delayed wound healing were also found to be lower in the LSPD group as compared to the OSPD group (p < 0.05). During a follow-up period of 6-70 months, no significant differences were found in the data for the two methods with respect to the incidence of rebleeding; hepatic encephalopathy; and survival (p > 0.05).

CONCLUSIONS

It was concluded that spleen bed LSPD is a safe and feasible procedure for treating elderly patients. It had a better clinical effect than that of OSPD.