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World J Gastroenterol. Dec 28, 2014; 20(48): 18420-18426
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18420
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18420
Modified laparoscopic splenectomy and azygoportal disconnection combined with cell salvage is feasible and might reduce the need for blood transfusion
Guo-Qing Jiang, Dou-Sheng Bai, Ping Chen, Jian-Jun Qian, Sheng-Jie Jin, Jie Yao, Xiao-Dong Wang, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Author contributions: Jiang GQ and Chen P contributed equally to this work; Jiang GQ, Chen P and Bai DS designed the research; Bai DS, Chen P, Qian JJ, Yao J and Jin SJ performed the research; Jiang GQ and Wang XD analyzed the data; Jiang GQ and Chen P wrote the paper.
Supported by Science and Education Foundation of Yangzhou, China
Correspondence to: Dou-Sheng Bai, MD, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, 98 West Nantong Rd, Yangzhou 225000, Jiangsu Province, China. bdsno1@hotmail.com
Telephone: +86-514-87373272 Fax: +86-514-87990188
Received: September 7, 2014
Revised: October 23, 2014
Accepted: December 1, 2014
Published online: December 28, 2014
Revised: October 23, 2014
Accepted: December 1, 2014
Published online: December 28, 2014
Core Tip
Core tip: Because of the impairment of hepatic synthetic function and intractable coagulopathy, one of the most serious complications during laparoscopic splenectomy and azygoportal disconnection (LSD) is rapid loss of large volumes of blood. Intraoperative cell salvage and autologous blood transfusion of splenic blood and operative hemorrhage during LSD can increase hemoglobin concentration and reduce or obviate the need for intraoperative allogeneic transfusion. An autologous blood salvage device can minimize intraoperative blood loss and make full use of the large red cell pool sequestered in an enlarged spleen. At the same time, it will encourage more surgeons to perform LSD.