The Clinical Research Of Laparoscopic Modified Sugiura Procedure For The Treatment Of Portal Hypertension

Objective:To study the methods and skills of laparoscopic modified sugiura procedure for the treatment of portal hypertension in cirrhotic patients and evaluated the feasibility, safety and operation effect of this procedure.Methods:We retrospectively study from March2004to August2010,15patients whom were diagnosed as cirrhosis, portal hypertension and splenomegaly,hypersplenism and gastroesophageal varices in our center received laparoscopic modified sugiura which included laparoscopic splenectomy,devascularization and esophageal transection. Observed the change of blood routine、degree of gastroesophageal varices、rebleeding and so on. Using statistical software SPSS13.0for statistical analysis, statistical methods: matched t-test and rank test, default P<0.05as statistically significant difference.Results:The operations were successful in all15patients, and no case was transferred to opening appendectomy. The average operative time was6.07hours, Mean blood loss was672ml.The patients recovered well and without any severe complications except1died after surgery, blood cells restored normal (P<0.05), degree of gastroesophageal varices were reduced(P<0.05), mean follow-up time was36months, one patient passed black stool after2years.Conclusions:laparoscopic modified Sugiura procedure is feasible and safe, minimally invasive and fast restored with excellent cosmetic result. Laparoscopic modified Sugiura procedure offers a new alternative for the treatment of portal hypertension, but this procedure should be performed in the team with good experience in laparoscopic surgery and skills.