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JSLS
2017 ; 21
(1
): ? Nephropedia Template TP
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Laparoscopic and Open Splenectomy and Hepatectomy
#MMPMID28352148
Li JF
; Bai DS
; Jiang GQ
; Chen P
; Jin SJ
; Zhu ZX
JSLS
2017[Jan]; 21
(1
): ? PMID28352148
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BACKGROUND AND OBJECTIVES: Patients undergoing synchronous open splenectomy and
hepatectomy (OSH) for concurrent hepatocellular carcinoma (HCC) and hypersplenism
usually have major surgical trauma caused by the long abdominal incision.
Surgical procedures that contribute to rapid recovery with the least possible
impairment are desired by both surgeons and patients. The objective of this study
was to explore outcomes in patients treated with simultaneous laparoscopic or
open splenectomy and hepatectomy for hepatocellular carcinoma (HCC) with
hypersplenism. METHODS: We retrospectively evaluated the treatment outcomes in 23
patients with cirrhosis, HCC, and hypersplenism, who underwent simultaneous
laparoscopic splenectomy and hepatectomy (LSH; n = 12) or open splenectomy and
hepatectomy (OSH; n = 11) from January 2012 through December 2015. Their
perioperative variables were compared. RESULTS: LSH was successful in all
patients. There were nonsignificant similarities between the 2 groups in duration
of operation, estimated blood loss, and volume of blood transfused (P > .05
each). Compared with OSH, LSH had a significantly shorter postoperative visual
analog scale pain score (P < .001); shorter time to first oral intake (P < .001),
passage of flatus (P < .05) and off-bed activity (P < .001); shorter
postoperative duration of hospitalization (P < .001); fewer days of postoperative
temperature >38.0°C (P < .01); fewer postoperative complications (P < .05); and
better liver and renal function on postoperative days 7 (P < .05 each).
CONCLUSIONS: Simultaneous LSH is safe for selected patients with HCC and
hypersplenism associated with liver cirrhosis.
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