Laparoscopic and Open Splenectomy and Hepatectomy.
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.
['Li|Jing-Feng|JF|', 'Bai|Dou-Sheng|DS|', 'Jiang|Guo-Qing|GQ|', 'Chen|Ping|P|', 'Jin|Sheng-Jie|SJ|', 'Zhu|Zhi-Xian|ZX|']
D000293:Adolescent D000328:Adult D000368:Aged D006528:Carcinoma, Hepatocellular D005240:Feasibility Studies D005260:Female D006498:Hepatectomy D006801:Humans D006971:Hypersplenism D010535:Laparoscopy D008103:Liver Cirrhosis D008113:Liver Neoplasms D008297:Male D008875:Middle Aged D012189:Retrospective Studies D013156:Splenectomy D016896:Treatment Outcome D055815:Young Adult
Splenectomy Hepatectomy Hepatocellular carcinoma Hypersplenism Laparoscopy