Outcome of laparoscopic splenectomy with sandwich treatment including pericardial devascularization and limited portacaval shunt for portal hypertension due to liver cirrhosis.

Abstract Aim: To investigate the feasibility, effectiveness, and safety of a combination therapy of laparoscopic splenectomy (LS) with pericardial devascularization (PD) (laparoscopic Hassab's procedure) with or without limited portacaval shunt (LPS) for patients with portal hypertension due to liver cirrhosis. Subjects and Methods: During September 2008 to April 2012, 42 patients underwent a combined treatment of LS with PD in our hospital. Of these subjects, 16 patients had an assessment of free portal vein pressure of more than 3.92–4.4 kPa and underwent a further limited LPS. Information on patients' demographics, diagnosis, and indication of splenectomy and perioperative variables was collected and analyzed. Results: All patients successfully survived the operation, and 2 patients required an intraoperative conversion to open splenectomy because of intraoperative bleeding. For patients with LS plus PD, the mean operating time was 145 minutes, and the estimated blood loss was 146.2 mL. For patients wh...