To observe the effect of total laparoscopic splenectomy (LSC) combined with pericardial devascularization (LPD) on immune function in patients with cirrhosis and portal hypertension with hypersplenism (CPHWH).

From January 2013 to January 2018, 77 patients with CPHWH were divided into laparoscopic group (36 cases) and laparotomy group (41 cases). All patients received laparoscopic surgery or laparotomy respectively. The differences of the related indexes and immune function at different time points (preoperative, POD 3 d , 9 d and 15 d) were compared between two groups. Statistical analysis were performed by using SPSS 19.0 software. Measurement data, such as immune function and inflammatory cytokine related indicators were expressed as(±s), and were examined by using independent t test. Count data such as postoperative complications were examined by chi square test. A P value <0.05 was considered as statistically significant difference.

Compared with the open group, laparoscopic group were significantly lower in terms of leucocyte count, C-reactive protein, appetite deprivation, intestinal dysphonia, occult blood in gastric juice, occult blood in stool and intestinal infection respectively (P<0.05). and the Ig G、Ig A、Ig M、CD3⁺ in both two groups were significantly lower at each time after operation respectively (POD 3 d、9 d and 15 d) (P<0.05). CD4⁺, CD4⁺ /CD8⁺ increased, while CD8⁺、IL-1、IL\【 and TNF-a decreased (P<0.05), however the decreases of laparoscopic indicators on POD 3 d and 9 d were lower than those in the open group respectively (P<0.05). There was no significant difference between two groups POD 15 d (P>0.05).

Compared with laparotomy, laparoscopic LSC+ LPD is beneficial to the early recovery of immune function after CPHWH operation, with reduced occurrence of adverse reactions after operation.