To investigate the early effect of laparoscopic hepatectomy combined with splenectomy on hepatocellular carcinoma with hypersplenism.

The clinical data of 54 patients of hepatocellular carcinoma with hypersplenism treated by laparoscopic surgery in our hospital were retrospectively analyzed. The patients who underwent liver cancer resection and splenectomy were included in splenectomy group, while those who underwent liver cancer resection and spleen preservation were included in spleen preserving group. The data were analyzed by SPSS24.0 statistical software, Among them, the number of complications and other counting data were expressed by n(%), and the results were compared with χ². The measurement data such as Perioperative indexes、peripheral blood indexes were expressed in (±s), and compared with Independent sample t test and paired t test, P<0.05 was considered statistically significant.

The operation was successfully completed in both groups without conversion to laparotomy. There were significant differences in operation time between the two groups (P=0.003), and no significant difference in intraoperative blood loss and postoperative hospital stay (P>0.05). The changes of WBC, PLT, liver function and immune function in peripheral blood of the two groups before and one week after operation were compared. There was no significant difference in preoperative indexes (P> 0.05). One week after operation, WBC and PLT in peripheral blood of the two groups were significantly higher than those before operation, and splenectomy group were significantly higher than those of spleen preserving group (P<0.05); ALT, AST and Tbil in the two groups were significantly higher than those before operation, while those in spleen preserving group were more significant than those in splenectomy group (P<0.05); CD4, CD4/CD8 in the immune function were not significantly changed after operation in spleen preserving group (P>0.05); CD4, CD4/CD8 in splenectomy group were not significant changes after operation (P>0.05). It was significantly higher than that of spleen preserving group, while CD8 was significantly lower than that of spleen preserving group (P<0.05). The incidences of early complications in splenectomy group and spleen preserving group were 16.0% and 17.2%, respectively. There was no significant difference between the two groups (P>0.05).

Laparoscopic hepatectomy combined with splenectomy is safe and feasible for the treatment of hepatocellular carcinoma with hypersplenism, which reduces the surgical trauma and is conducive to the recovery of patients after operation, and the early treatment effect is satisfactory.