ArticleJournal of minimal access surgery
Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series.
Article in Journal of minimal access surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors at 2 institutions in 2 countries.
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Abstract
backgroundSplenectomy for the treatment of hypersplenism in patients with cirrhosis (HIC) is related with complications. Laparoscopic splenic artery ligation (LSAL) may be an alternative treatment option.
aimsTo evaluate safety and feasibility of LSAL in the treatment of HIC. PATIENTS AND
methodsRetrospective analysis of prospectively collected data of ten patients with HIC who were treated with LSAL from October 2012 to February 2015.
resultsThe median (range) age was 33.2 (13-56) years and sex distribution was equal. The median (range) leukocyte counts (×10(9)/L) before, and at 3, 6 and 12 months after LSAL were 2.2 (0.8-8.2) and 5.65 (2.78-10.7), 4.7 (2.8-7.8) and 4.95 (3.4-7.7) respectively. The median (range) platelet counts (×10(9)/L) before and at 3, 6 and 12 months after LSAL were 25.5 (11-65) and 75 (39-289), 74 (32-184) and 76 (56-251) respectively. Following LSAL, there was a significant improvement in total leucocyte count, platelet count and Model for End-Stage Liver Disease (MELD) score (P < 0.05). Two patients (20%) developed intraoperative bleeding and required conversion; one of these two patients developed splenic cyst that required radiological intervention. Four patients (40%) had post ligation syndrome (PLS) that was managed conservatively. During a median (range) follow-up of 19.5 (5-29) months, one patient (10%) required splenectomy due to inadequate response.
conclusionLSAL is a safe and feasible treatment option for the palliation of symptomatic HIC, however, further prospective trials are necessary for confirmation.
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