To observe and to compare the efficacy of laparoscopic and laparotomy splenectomy and pericardial devascularization in the treatment of portal hypertension.

From March 2013 to December 2018, clinical data of patients with portal hypertension for splenomegaly, hypersplenism and esophageal and gastric fundus varices were analyzed retrospectively, among them, 21 cases underwent laparoscopic splenectomy and pericardial devascularization (laparoscopic group) and 50 cases underwent laparotomy of splenectomy and pericardial devascularization (laparotomy group). Statistical analysis were performed by using GraphPad Prism 6.0 software. Measurement data such as intraoperative and postoperative indicators were expressed as (±s) and examined by using independent t-test. The complication rate were compared by using χ² test. Survival were analyzed by using Kaplan Meier method, and were examined by using log rank test. A P value of <0.05 was considered as statistically significant difference.

Compared with laparotomy group, in addition to much longer operating time(P<0.05), there were advantages observed in the laparoscopic group including intraoperative blood loss, length of incision, time of first postoperative flatus, usage of analgesics, removal time of drainage tube, postoperative hospital stay and postoperative incision infection rate (P<0.05). There were no significant differences between two groups in terms of abdominal bleeding, peritoneal and pelvic effusion, pulmonary infection, pancreatic fistula and portal vein thrombosis (P>0.05).

Laparoscopic splenectomy and pericardial devascularization for the treatment of portal hypertension has the advantages of less surgical trauma, less intraoperative bleeding, faster postoperative recovery, lower incidence of postoperative incision infection, and shorter hospital stay. Laparoscopic surgery for the treatment of portal hypertension is safe and feasible.