Surgical laparoscopy, endoscopy & percutaneous techniques · 2009
The feasibility and effectiveness of a hand-assisted laparoscopic splenectomy for hypersplenism in patients after living-donor liver transplantation.
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Uehara Hideo, Kawanaka Hirofumi, Akahoshi Tomohiko, Tomikawa Morimasa, Kinjo Nao, Hashimoto Naotaka, Ikegami Toru, Soejima Yuuji, Taketomi Akinobu, Maehara Yoshihiko
Аннотация
BACKGROUND: A laparoscopic splenectomy in patients who previously underwent living-donor liver transplantation (LDLT) is thought to be technically difficult because of the presence of severe adhesions and splenomegaly. This report documents the efficacy and safety of a hand-assisted laparoscopic splenectomy (HALS) for hypersplenism in patients after LDLT.
METHODS: Five patients underwent HALS for hypersplenism after LDLT between 1999 and 2007. The medical records of those patients were retrospectively evaluated.
RESULTS: The mean operative time was 237+/-12 minutes. The mean blood loss was 229+/-100 mL and the mean weight of excised spleen was 461+/-46 g. There was no conversion to open surgery. The number of platelets and leukocytes were significantly increased after surgery. No major complications were observed except for a patient who suffered paralytic ileus postoperatively. The mean hospital stay after the operation was 16.7+/-2.5 days.
CONCLUSIONS: HALS for patients after LDLT is a feasible and safe procedure. This technique can thus become a standard procedure after LDLT.
METHODS: Five patients underwent HALS for hypersplenism after LDLT between 1999 and 2007. The medical records of those patients were retrospectively evaluated.
RESULTS: The mean operative time was 237+/-12 minutes. The mean blood loss was 229+/-100 mL and the mean weight of excised spleen was 461+/-46 g. There was no conversion to open surgery. The number of platelets and leukocytes were significantly increased after surgery. No major complications were observed except for a patient who suffered paralytic ileus postoperatively. The mean hospital stay after the operation was 16.7+/-2.5 days.
CONCLUSIONS: HALS for patients after LDLT is a feasible and safe procedure. This technique can thus become a standard procedure after LDLT.