Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series
Background: Splenectomy for the treatment of hypersplenism in patients with cirrhosis (HIC) is related with complications. Laparoscopic splenic artery ligation (LSAL) may be an alternative treatment option. Aims: To evaluate safety and feasibility of LSAL in the treatment of HIC. Patients and Method...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Journal of Minimal Access Surgery |
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| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=4;spage=334;epage=337;aulast=Nag |
| _version_ | 1819160468769472512 |
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| author | Hirdaya H Nag Sandip Chandrasekar John M Manipadum Bettageri G Vageesh |
| author_facet | Hirdaya H Nag Sandip Chandrasekar John M Manipadum Bettageri G Vageesh |
| author_sort | Hirdaya H Nag |
| collection | DOAJ |
| description | Background: Splenectomy for the treatment of hypersplenism in patients with cirrhosis (HIC) is related with complications. Laparoscopic splenic artery ligation (LSAL) may be an alternative treatment option. Aims: To evaluate safety and feasibility of LSAL in the treatment of HIC. Patients and Methods: Retrospective analysis of prospectively collected data of ten patients with HIC who were treated with LSAL from October 2012 to February 2015. Results: The median (range) age was 33.2 (13-56) years and sex distribution was equal. The median (range) leukocyte counts (×109/L) before, and at 3, 6 and 12 months after LSAL were 2.2 (0.8-8.2) and 5.65 (2.78-10.7), 4.7 (2.8-7.8) and 4.95 (3.4-7.7) respectively. The median (range) platelet counts (×109/L) before and at 3, 6 and 12 months after LSAL were 25.5 (11-65) and 75 (39-289), 74 (32-184) and 76 (56-251) respectively. Following LSAL, there was a significant improvement in total leucocyte count, platelet count and Model for End-Stage Liver Disease (MELD) score (P < 0.05). Two patients (20%) developed intraoperative bleeding and required conversion; one of these two patients developed splenic cyst that required radiological intervention. Four patients (40%) had post ligation syndrome (PLS) that was managed conservatively. During a median (range) follow-up of 19.5 (5-29) months, one patient (10%) required splenectomy due to inadequate response. Conclusion: LSAL is a safe and feasible treatment option for the palliation of symptomatic HIC, however, further prospective trials are necessary for confirmation. |
| first_indexed | 2024-12-22T16:56:56Z |
| format | Article |
| id | doaj.art-b807d20f9e2d4d69994b3a1184c56b29 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-22T16:56:56Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-b807d20f9e2d4d69994b3a1184c56b292022-12-21T18:19:26ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212016-01-0112433433710.4103/0972-9941.181288Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case seriesHirdaya H NagSandip ChandrasekarJohn M ManipadumBettageri G VageeshBackground: Splenectomy for the treatment of hypersplenism in patients with cirrhosis (HIC) is related with complications. Laparoscopic splenic artery ligation (LSAL) may be an alternative treatment option. Aims: To evaluate safety and feasibility of LSAL in the treatment of HIC. Patients and Methods: Retrospective analysis of prospectively collected data of ten patients with HIC who were treated with LSAL from October 2012 to February 2015. Results: The median (range) age was 33.2 (13-56) years and sex distribution was equal. The median (range) leukocyte counts (×109/L) before, and at 3, 6 and 12 months after LSAL were 2.2 (0.8-8.2) and 5.65 (2.78-10.7), 4.7 (2.8-7.8) and 4.95 (3.4-7.7) respectively. The median (range) platelet counts (×109/L) before and at 3, 6 and 12 months after LSAL were 25.5 (11-65) and 75 (39-289), 74 (32-184) and 76 (56-251) respectively. Following LSAL, there was a significant improvement in total leucocyte count, platelet count and Model for End-Stage Liver Disease (MELD) score (P < 0.05). Two patients (20%) developed intraoperative bleeding and required conversion; one of these two patients developed splenic cyst that required radiological intervention. Four patients (40%) had post ligation syndrome (PLS) that was managed conservatively. During a median (range) follow-up of 19.5 (5-29) months, one patient (10%) required splenectomy due to inadequate response. Conclusion: LSAL is a safe and feasible treatment option for the palliation of symptomatic HIC, however, further prospective trials are necessary for confirmation.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=4;spage=334;epage=337;aulast=NagComplicationscirrhosishypersplenismsplenectomysplenic artery (SA) ligation |
| spellingShingle | Hirdaya H Nag Sandip Chandrasekar John M Manipadum Bettageri G Vageesh Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series Journal of Minimal Access Surgery Complications cirrhosis hypersplenism splenectomy splenic artery (SA) ligation |
| title | Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series |
| title_full | Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series |
| title_fullStr | Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series |
| title_full_unstemmed | Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series |
| title_short | Laparoscopic splenic artery ligation for hypersplenism in cirrhosis: A case series |
| title_sort | laparoscopic splenic artery ligation for hypersplenism in cirrhosis a case series |
| topic | Complications cirrhosis hypersplenism splenectomy splenic artery (SA) ligation |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=4;spage=334;epage=337;aulast=Nag |
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