Is Laparoscopic Splenectomy (LS) of Benefits for Hypersplenism Secondary to Portal Hypertension?
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- Category: Vol. 85, March 2017
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Is Laparoscopic Splenectomy (LS) of Benefits for Hypersplenism Secondary to Portal Hypertension?, EL-SAYED A. ABD EL-MABOOD, REFAAT S. SALAMA and BADAWY A. ABDUL AZIZ
Abstract
Background: Laparoscopic splenectomy has become the gold-standard procedure for normal to moderately enlarged spleens. However, the safety of laparoscopic splenectomy for patients with portal hypertension remains controversial.
Patients and Methods: This prospective study was con-ducted on 16 patients diagnosed with hypersplenism secondary to portal hypertension; 5 (31.25%) females and 11 (68.75%) males. All patients had preoperative gastroscopy and laparo-scopic splenectomy was done and follow-up was for 6 months.
Results: Despite mean operative time was: 136.4±5.6 which is higher if compared with open surgery; the mean blood loss was less (766.9±11.3) and Postoperative (PO) hospital stay (days) was also less (4.7±1.2). Conversion to laparotomy was 18.75%. No major complications except postoperative bleeding that was noticed in 25%, three of them needed re-do. There was improvement in esophageal varices grade I with p-value=0.003 and grade II with p-value=0.005 on gastroscopy.
Conclusions: Although laparoscopic splenectomy is as-sociated with longer operating time, it is a feasible, effective and safe procedure that offers advantages in terms of less blood loss, lower operative complications, shorter post hospital stay and better quality-of-life outcomes. With gaining expe-rience and proper case selection; progressively larger spleens can be removed using laparoscopy.