Efficacy of Hand-Assisted Laparoscopic Splenectomy for Portal Hypertension Patients with Thrombocytopenia

Peg-interferon and ribavirine therapy is promising for hepatitis C virus positive patients; however thrombocytopenia as its adverse event limits the treatment. We perform hand-assisted laparoscopic (HALS) splenectomy tonincrease the thorombocyte before interferon treatment for patients with thrombocytopenia.
From March, 2006 to August 2008, we performed HALS splenectomy in 26 patients. 5 cases underwent Hassab operation. An 8 cm median skin incision was made in the upper abdomen and GelPortTM was placed. 3 trocars were placed at the left side of umbilicus. Spleen was mobilized with spatula type electric cautery and LCS. Surgeonfs left hand made a good operation field. The splenic vessels were ligated with intracorporeal one hand ligation technique, and the splenic hilus was sealed and cut with LigaSureTM. The spleen was taken out in a plastic bag through the median incision.
3 cases were converted to open, 2 of which had history of interventional therapies for esophageal varices or hepatocellular carcinoma. Mean splenic weight, operating time, and blood loss of all cases were 506.0g, 181.7min and 390.2ml, respectively. Those with histories of preoperative interventions such as EIS, PSE, TAE, and RF showed heavier spleen (p=0.001), longer operation time (p


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Program Number: P530

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