Objective To evaluate the effect of laparoscopic splenectomy (LS) and open splenectomy (OS) for
hypersplenism secondary to liver cirrhosis with portal hypertension.
Methods Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline, Embase, CINAHL, CBM, CNKI, VIP and WanFang database were searched for randomized control trials or retrospective studies related to the effect of LS and OS for hyper-splenism secondary to liver cirrhosis with portal hypertension. Then studies were screened according to the inclusion and exclusion criterias, data were collected, and quality of studies were evaluated. RevMan 5.1.0 software was used for meta-analysis.
Results Seventeen retrospective studies and one randomized control trial were enrolled. The results of meta analysis showed that, the estimated blood loss, postoperative hospital stay, rate of postoperative complication, and WBC level on 1 day after operation of LS group were significantly lower or shorter than those of OS group (P<0.05). However, there were no significant differences on operative time, WBC level on 7 days after operation, postoperative platelets (1 day and 7 days after operation), alanine aminotransferase (1 day and 7 days after operation), and total bilirubin (1 day and 7 days after operation) between LS group and OS group (P>0.05).
Conclusions LS may be more effective to reduce blood loss, postoperative hospital stay, and rate of postoperative complication in patients with hypersplenism secondary to liver cirrhosis with portal hypertension in comparison to OS. However, the effectiveness of LS on liver function is not clear.
Citation: TIAN Lang,HU Yong,FENG Xielin,LIU Aixiang,ZHANG Hui,PENG Junping. Systematic Review of Effect of Laparoscopic Splenectomy and Open Splenectomy for Hypersplenism Secondary to Liver Cirrhosis with Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(3): 293-302. doi: Copy