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An effective method for intraoperative hemorrhage control during laparoscopic partial splenectomy

Yongbin Li1, Bing Peng2. 1Hepatopancreatobiliary Minimally Invasive Surgery, ShangJin NanFu Hospital, Chengdu, 610063, China, 2Pancreatic Surgery, Westchina Hospital, Sichuan University, Chengdu, 610041, China

Abstract: Background:Intraoperative hemorrhage control is a technical challenge to perform laparoscopic partial splenectomy(LPS). This  study  evaluated  our  new  strategy with performing intraoperative splenic artery occlusion(ISAO)by bulldog clamp during LPS.

Methods: Patients with either focal benign splenic lesion or traumatic splenic rupture who underwent LPS from May 2011 to Sep 2017 at Westchina hospital of Sichuan university were included.All of the operations were performed by a single skilled surgeon.We divided our patients into two groups based on whether ISAO was used. Of them,28 patients received ISAO for LPS and 26 patients received LPS without ISAO.Surgical skills and safety were evaluated.

Results: There were no significant differences in preoperative  patients  characteristics  of  the  two  groups. Significantly less intraoperative  blood  loss(78.1±34.0 ml vs 177.5±81.3 ml;t=-6.4, P=0.001) were observed in group of ISAO.There were no significant differences between the ISAO group and without ISAO group in terms of the operative time(112.7±17 min vs 127.4±40 min; t=-2.4, P=0.21),and transfusion rate(0/28,0/26;Fisher =0,P=1),conversion rate(0/28,0/26;Fisher =0,P=1), thrombocytosis(0/28,0/26;Fisher =0,P=1),left subdiaphragmatic effusion(2/28,2/26;Fisher =0,P=0.66), splenic vein thrombosis e(0/28,0/26;Fisher =0,P=1) and length of postoperative hospital stay(5.8±1.3 days vs 6.0±1.3 days;t=3.58, P=0.25).

Conclusions: ISAO is technically feasible,safe surgical skills for patients reveived LPS, and its represents an effective method to decreased intraoperative blood loss.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87653

Program Number: P685

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

Post Views: 10

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