ArticleSurgical endoscopy2026
Effects of laparoscopic splenectomy and azygoportal disconnection on immune remodeling in cirrhosis patients with portal hypertension bleeding: a 1-year prospective study.
Article in Surgical endoscopy, 2026. 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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Abstract
aimThis study aimed to characterize immune remodeling following laparoscopic splenectomy and azygoportal disconnection (LSD) in patients with cirrhotic portal hypertension.
methodsIn this 1-year prospective study, a total of 49 patients with cirrhotic portal hypertension received LSD treatment. We analyzed the dynamic changes in immune function-related indices through serial assessments conducted preoperatively and at 1, 3, 6, and 12 months postoperatively (POM 1, 3, 6, 12), specifically focusing on CD4+ T cell, CD8+ T cell, and CD19+.CD20+ B cell.
resultsPostoperative immune function was remodeled: the relative count of CD4⁺ T cells decreased progressively from 59.13% (53.49%, 69.40%) preoperatively to 43.00% (40.76%, 47.63%) at POM 12, a significant decline of 27.28% (P < 0.001). The relative count of CD8⁺ T cells increased progressively from 29.66% (22.25%, 34.47%) preoperatively to 46.00% (39.47%, 50.52%) at POM 12, a significant rise of 55.09% (P < 0.001). The CD4⁺/CD8⁺ T cell ratio decreased from 2.44 ± 1.19 preoperatively to 1.03 ± 0.51 at POM 12, a significant reduction of 57.79% (P < 0.001). The relative count of CD19⁺/CD20⁺ B cells declined from 19.61 ± 9.44% preoperatively to 10.09 ± 4.33% at POM 12, a significant decrease of 48.55% (P < 0.001). Statistically significant differences were observed in all four immune parameters when comparing preoperative levels with those at POM 1, 3, 6, and 12 (all P < 0.001).
conclusionLSD effectively changes peripheral immune profiles associated with cirrhotic portal hypertension.
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