Laparoscopic Versus Open Splenectomy And Esophagogastric Devascularization For Portal Hypertension: A Meta Analysis

Objective: The aim of this study was to assess the safety and feasibility of laparoscopic versus open splenectomy and esophagogastric devascularization for portal hypertension by Meta analysis. Methods: Controlled trials comparing LS and OS in portal hypertension were electronically searched from Wan Fang Data Knowledge Service Platform.medalink.CNKI.PubMed.Elsevier.SpringerLink and CBMdisc. The last retrieval date was in April 2015,All relevant data and their references were also retrieved by hand.Finally RevMan 5.2 was used for data analysis. Results: Eventually 7 RCTs or quality trials involving 468 patients were included, Meta analysis results indicated that: LS reduced the blood loss [WMD=214.67,95%CI(198.74,230.60),p<0.00001], LS also shortened the passing of flatus[WMD=17.72,95%CI(12.39,23.04),p<0.00001] and postoperative hospital stay[WMD=3.75,95%CI(3.28,4.23),p<0.00001], and duration of surgery were shorter(p=0.028) in the OS. However, OS was the same as LS in complication rate. Conclusions: Comparing with OS, LS has the advantage of reducing the intraoperative haemorrhage and shortening the recovery time of postoperation.In the treatment of liver cirrhosis with portal hypertension stomach esophagus varicosity,laparoscopic splenectomy is safety and effective and has a great clinical application prospect.