Laparoscopic and Open Splenectomy and Hepatectomy

Abstract

Background and Objectives:Patients undergoing synchronous open splenectomy and hepatectomy (OSH) for concurrent hepatocellular carcinoma (HCC) and hypersplenism usually have major surgical trauma caused by the long abdominal incision. Surgical procedures that contribute to rapid recovery with the least possible impairment are desired by both surgeons and patients. The objective of this study was to explore outcomes in patients treated with simultaneous laparoscopic or open splenectomy and hepatectomy for hepatocellular carcinoma (HCC) with hypersplenism.Methods:We retrospectively evaluated the treatment outcomes in 23 patients with cirrhosis, HCC, and hypersplenism, who underwent simultaneous laparoscopic splenectomy and hepatectomy (LSH; n = 12) or open splenectomy and hepatectomy (OSH; n = 11) from January 2012 through December 2015. Their perioperative variables were compared.Results:LSH was successful in all patients. There were nonsignificant similarities between the 2 groups in duration of operation, estimated blood loss, and volume of blood transfused (P > .05 each). Compared with OSH, LSH had a significantly shorter postoperative visual analog scale pain score (P < .001); shorter time to first oral intake (P < .001), passage of flatus (P < .05) and off-bed activity (P < .001); shorter postoperative duration of hospitalization (P < .001); fewer days of postoperative temperature >38.0°C (P < .01); fewer postoperative complications (P < .05); and better liver and renal function on postoperative days 7 (P < .05 each).Conclusions:Simultaneous LSH is safe for selected patients with HCC and hypersplenism associated with liver cirrhosis.

Primary splenic malignant lymphoma mimicking metastasis of rectosigmoid cancer: A case report

“…In this case, we could omit the left subcostal incision by mobilizing the spleen laparoscopically from the retroperitoneum, and could resect the tumors in the right lobe of the liver and the spleen using an open procedure with a J-shaped subcostal incision. Experienced laparoscopic surgeons might perform the entire partial right hepatectomy and splenectomy procedures, from start to finish, laparoscopically within a reasonable operative period [ 9 ].…”

Current status of radical laparoscopy for treating hepatocellular carcinoma with portal hypertension

“…Nevertheless, the simultaneous utilization of open hepatectomy and splenectomy (OHS) means that HCC with hypersplenism patients have to endure severe surgical trauma resulted by an immense inverse L-shaped incision. Li et al [ 51 ] proved the superior short-term prognosis of laparoscopic hepatectomy and splenectomy (LHS) over OHS via clinical investigation, and observation indexes favoring LHS included postoperative complications probability, LOS, and visceral function. These investigators consequently insisted that LHS eliminated relevant contraindications and was a superb minimally-invasive surgery with high security and effectiveness for HCC with hypersplenism.…”

Treatment and outcomes of two pigs treated for hemoabdomen secondary to splenic disease

“…Splenectomy is commonly performed to treat hematological disorders, myeloproliferative disease, and neoplasia [1][2][3][4][5][6] in man. This procedure is also common in dogs, to treat splenic nodules, hemoabdomen and selected cases of gastric dilation and volvulus.…”