To explore the feasibility, effectiveness and safety of total laparoscopic splenectomy and pericardial cardia vascular dissection in the treatment of portal hypertension with cirrhosis.

The clinical data of 121 cases of total laparoscopic splenectomy and pericardial devascularization performed in our department from January in 2014 to December in 2017 were retrospectively analyzed.

115 cases were successfully completed by laparoscopic splenectomy and pericardial devascularization, 6 cases were transferred to open surgery, the operation time was 95~325 min, average 162min, the intraoperative hemorrhage was 100~1600 ml, average 285 ml, and postoperative hospitalization time was 6 to 20 d, mean 8.6 d. Postoperative abdominal bleeding occurred in 3 cases, laparotomy was performed to stop bleeding in 2 cases for the massive bleeding, 1 cases were treated by conservative treatment. There were 9 cases of mild ascites, 7 cases of pleural effusion, 1 cases of pancreatic pseudocyst, 2 cases of pulmonary infection, and no perioperative death. After 3~50 months of follow-up, there were 13 cases of portal vein thrombosis, 4 cases of recurrent ascites, 4 cases of alimentary tract rebleeding, among which 1 cases of hemostasis was treated with gastroscope, 1 cases was treated with TIPS, the 2 other cases was died for hemorrhagic shock. And 1 cases was died for liver failure.

Total laparoscopic splenectomy and pericardial devascularization is a safe and effective minimally invasive procedure for the treatment of cirrhosis of the portal hypertension.