![]() ![]() Laparoscopic splenectomy (LS) is still challenging in patients with liver cirrhosis and portal hypertension. Kawanaka, Hirofumi Akahoshi, Tomohiko Kinjo, Nao Harimoto, Norifumi Itoh, Shinji Tsutsumi, Norifumi Matsumoto, Yoshihiro Yoshizumi, Tomoharu Shirabe, Ken Maehara, Yoshihiko Laparoscopic Splenectomy with Technical Standardization and Selection Criteria for Standard or Hand-Assisted Approach in 390 Patients with Liver Cirrhosis and Portal Hypertension. ![]() Although our data are preliminary, hand-assisted laparoscopic devascularization and splenectomy proved an effective procedure for treating esophagogastric varices in patients with portal hypertension. Bleeding from esophagogastric varices was not observed during the follow-up period. Esophagogastric varices in all patients disappeared or improved. Those complications were treated successfully without re-operation. Four postoperative complications (massive ascites, enteritis, intra-abdominal abscess, and intestinal ulcer) were observed in two patients. During a median 21 (range 3-43) months of follow-up, the mortality rate was 0%. The median postoperative hospital stay was 21 (range 13-81) days. The conversion rate to open surgery was 0%. The median weight of removed spleen was 507 (range 242-1835) g. The median intraoperative blood loss was 695 (range 15-2395) ml. The median operative time was 455 (range 310-671) min. We retrospectively reviewed the medical records for the perioperative variables, postoperative mortality and morbidity, and postoperative outcomes of esophagogastric varices. Four men and three women with a median age of 61Â years (range 35-71) were enrolled in this series. From 2009 to 2016, seven patients with esophagogastric varices with portal hypertension were treated with hand-assisted laparoscopic devascularization and splenectomy in our institute. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. Kobayashi, Takashi Miura, Kohei Ishikawa, Hirosuke Soma, Daiki Zhang, Zhengkun Ando, Takuya Yuza, Kizuki Hirose, Yuki Katada, Tomohiro Takizawa, Kazuyasu Nagahashi, Masayuki Sakata, Jun Kameyama, Hitoshi Wakai, Toshifumi Hand-assisted laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension. ![]()
0 Comments
Leave a Reply. |