• Zhi-Cheng Deng, Wen-Zhu Jiang, Lu Chen, Xiao-Dong Tang, and Shuang-Hai Liu.
• Department of Hepatobiliary Surgery, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, 214400, Jiangsu Province, China. Electronic address: angelmancity@126.com.
• Int J Surg. 2020 Aug 1; 80: 79-83.

BackgroundWe compared laparoscopic splenectomy combined with oesophagogastric devascularisation vs. open splenectomy combined with oesophagogastric devascularisation in patients with portal hypertension secondary to liver cirrhosis.Materials And MethodsThis study included 192 patients diagnosed with portal hypertension and severe gastroesophageal varices at our hospital between January 2002 and December 2018; 62 patients underwent laparoscopic splenectomy combined with oesophagogastric devascularisation (laparoscopic group), and 130 patients underwent the open procedure (open group). The results and outcomes were compared retrospectively.ResultsThe median blood loss was significantly less in the laparoscopic group than in the open group (180 vs. 380 mL, P < 0.001). The length of hospitalisation was shorter (6 vs. 11 days, P < 0.001) and the complication rate was lower in the laparoscopic group (P < 0.001). The general complication rates were 23.8% and 4.8% (P < 0.001), and the surgical complication rates were 56.1% and 24.2% (P < 0.001) in the open and laparoscopic groups, respectively. During a postoperative follow-up period of 10-60 months, the incidence of oesophagogastric variceal rebleeding showed no significant difference between groups.ConclusionLaparoscopic splenectomy combined with oesophagogastric devascularisation is technically feasible and safe in selected patients. Compared with the open group, the laparoscopic group showed a less volume of blood loss, shorter length of hospitalisation, and fewer postoperative complications but similar long-term outcomes.Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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