Laparoscopic and Open Splenectomy for Splenomegaly Secondary to Liver Cirrhosis: An Evaluation of Immunity

Bing Peng, PhD, Zhong Wu, MD, Jin Zhou, MD. West China Hospital, Sichuan University

 

Abstract
Objective: To investigate the perioperative inflammatory response and immunological effects of patients with splenomegaly due to portal hypertension who underwent laparoscopic (LS) or open splenectomy (OS).
Methods: Between May 2009 and September 2010, a total of 34 patients with splenomegaly due to portal hypertension underwent either laparoscopic (n=18) or open splenectomy (n=16) in this prospective study. Peripheral venous blood samples were taken from these patients prior to surgery as well as on postoperative days (POD) 1, 3 and 7. The perioperative clinical outcomes and immune function results were analyzed and compared within each surgical group.
Results: No difference was found in the demographic data between the two groups. Patients in the LS group had more operating time, less intraoperative blood loss, an earlier resumption of diet and shorter postoperative hospital stay. On POD 1 and 3, there were statistically significant differences in IL-6 and C – reactive protein levels, as well as in total lymphocytes, CD4 T cells and NK cells compared with presplenectomy in both the open and the laparoscopic group. The immune responses in the LS group were significantly less than those in the OS group. On POD 7, the LS group had a better preserved cellular immune response than the OS group, in addition to a faster recovery.
Conclusions: The study demonstrated that there are significant differences in the immune response depending on whether LS or OS was performed by examination of the inflammatory reaction and cellular immune response. Further human studies are required to determine the permanent effects on immune function following splenectomy.
 


Session Number: Poster – Poster Presentations
Program Number: P338
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