Abstract:
Objective To compare the effect of different management methods of splenic pedicle vessels in laparoscopic splenectomy for cirrhotic portal hypertension.
Methods The clinical data of 129 patients with cirrhotic portal hypertension who underwent surgical treatment from September 2017 to February 2020 were retrospectively analyzed. They were divided into group A（n=67，residual splenic artery length ≥ splenic vein）and group B（n=62，residual splenic artery length < splenic vein）according to the different treatment methods of splenic pedicle vessels during operation. SPSS 26.0 statistical analysis software was used. The indexes related to surgery and postoperative pain were expressed as（
±s），and independent sample
t test was used. The incidence of postoperative portal vein thrombosis（PVT）was analyzed by
χ2 test.
P<0.05 was considered statistically significant.
Results There were no significant differences in operation time，intraoperative blood loss，postoperative ambulation time，postoperative gastrointestinal decompression time，and hospital stay between the two groups（P>0.05）. The diameter，maximum velocity and blood flow of portal vein in group A were higher than those in group B at 1 week after operation（P<0.05）. The incidence of postoperative PVT in group A was 10.4% lower than that in group B 27.4%（P<0.05）.
Conclusion In the treatment of cirrhotic patients with portal hypertension by laparoscopic splenectomy，the length of residual splenic artery should not be shorter than that of splenic vein，which can effectively improve liver hemodynamic indexes and reduce the risk of postoperative PVT，and has high clinical application value.
Key words:
Liver cirrhosis,
Hypertension, portal,
Splenectomy,
Laparoscopes,
Splenic pedicle vessels,
Postoperative complications
Jumei Zhang, Yurong Huang, Didi Wang, Qiang Li, Xia Wu, Jie Yang. Comparison of different management methods of splenic pedicle vessels in laparoscopic splenectomy for portal hypertension of liver cirrhosis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(06): 643-646.