A Safe Approach To The Splenic Hilum Through Establishing A Tunnel Behind The Splenic Hilum In Laparoscopic Splenectomy

Objective To discuss the surgical skills and clinical value of laparoscopic splenectomy with a safe approach to the splenic hilum through establishing a tunnel behind the splenic hilum.Methods 88 laparoscopic splenectomys were performed for hypersplenism secondary to liver cirrhosis between September 2015 and September 2016.We divided our patients into two groups based on whether patients underwent a safe approach to the splenic hilum through establishing a tunnel behind the splenic hilum in laparoscopic splenectomy.Results compared with patients who did not underwent a safe approach to the splenic hilum through establishing a tunnel behind the splenic hilum in laparoscopic splenectomy,patients underwent a safe approach to the splenic hilum through establishing a tunnel behind the splenic hilum in laparoscopic splenectomy required less operation time(194.69±47.99 vs.232.75±45.26 min,P<0.01)and had less estimated blood loss(247.50±135.89 vs.361.75±144.43 ml,P<0.01).No significant difference was found in terms of blood transfusion,conversion,postoperative hospital stay.After operation,one patient developed esophageal fistula in experimental group.The patient was cured byconservative therapy and was discharged on the 31 st day after operation.No mortality occurred in our series.Conclusion It is safe and feasible to perform a safe approach to the splenic hilum through establishing a tunnel behind the splenic hilum in laparoscopic splenectomy.The technique is generalized in clinics,especially for freshmen.