Qi RZ, Li ZW, Chang ZY, Chang WH, Zhao WL, Pang C, Zhang Y, Hu XL, Liang F. Clinical efficacy of total laparoscopic splenectomy for portal hypertension and its influence on hepatic hemodynamics and liver function. World J Gastrointest Surg 2023; 15(8): 1684-1692 [PMID: 37701706 DOI: 10.4240/wjgs.v15.i8.1684]
Corresponding Author of This Article
Feng Liang, PhD, Doctor, Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, No. 8 Dongdajie, Fengtai District, Beijing 100039, China. lfpeakcool@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rui-Zhao Qi, Zheng-Yao Chang, Wei-Hua Chang, Wen-Lei Zhao, Chuan Pang, Ying Zhang, Xing-Long Hu, Feng Liang, Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
Zhi-Wei Li, Department of Hepatobiliary, The 3rd People’s Hospital of Shenzhen, Shenzhen 518112, Guangdong Province, China
Author contributions: Qi RZ and Li ZW contributed equally to this work and are co-first authors; Qi RZ and Li ZW contributed to the research design and thesis writing; Chang ZY, Liang F and Chang WH collected and analyzed the data; Qi RZ, Li ZW, Zhao WL and Pang YZ contributed to the data collection; Liang F overall supervise the study; all authors contributed to the article and approved the submitted version.
Institutional review board statement: The study was reviewed and approved by the Chinese PLA General Hospital Institutional Review Board (Approval No. 2010068D).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Liang, PhD, Doctor, Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, No. 8 Dongdajie, Fengtai District, Beijing 100039, China. lfpeakcool@126.com
Received: April 6, 2023 Peer-review started: April 6, 2023 First decision: April 19, 2023 Revised: May 16, 2023 Accepted: June 6, 2023 Article in press: June 6, 2023 Published online: August 27, 2023
ARTICLE HIGHLIGHTS
Research background
In addition to the resulting adverse effects on portal blood entering the liver that lead to decreased liver function in patients, portal hypertension (PH) can also induce liver hemodynamic changes that are closely related to many complications, warranting more clinical attention to this disease.
Research motivation
To help people gain a better understanding of the clinical effect of total laparoscopic splenectomy (TLS) in the treatment of PH.
Research objectives
The clinical effect of TLS on PH and its effect on liver hemodynamics and liver function are analyzed through case discussion and literature review.
Research methods
The clinical efficacy, surgical indexes, safety, liver hemodynamics, and liver function were compared between the observation group (n = 100) receiving TLS and the reference group (n = 99) receiving open splenectomy.
Research results
Although the operation time was significantly longer compared with the reference group, the overall response rate was significantly higher and the intraoperative blood loss and incidence of postoperative complications were significantly lower in the observation group. The detection of liver hemodynamics and liver function revealed significantly lower liver hemodynamics (blood vessel diameter, blood flow velocity and blood flow volume) and liver function indexes in the observation group vs the reference group 2 wk after surgery.
Research conclusions
For the treatment of PH, TLS is significantly better than open splenectomy in clinical efficacy, reducing the risk of postoperative complications in patients and improving their liver hemodynamics and liver function.
Research perspectives
In addition to clinical efficacy, we believe that future research and exploration of PH could also focus on the influence on liver hemodynamics and liver function, so as to further screen and optimize the clinical treatment of PH and improve patient outcomes.
