Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Jul 21, 2014; 20(27): 9146-9153
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9146
Table 1 Baseline demographic and clinical characteristics of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
VariableMLSD (n = 44)OSD (n = 71)P value
Gender, M/F, n27/1741/300.701
Age, mean ± SD, yr54.98 ± 10.4152.46 ± 10.330.209
Etiology, n
HBV cirrhosis23460.183
HCV cirrhosis350.963
Schistosome cirrhosis690.882
Alcoholic cirrhosis340.796
Autoimmunity liver cirrhosis970.111
APACHE II score, mean ± SD3.32 ± 2.273.49 ± 2.570.712
Child-Pugh classification, A/B, n29/1539/320.244
Longitudinal diameter of spleen, mean ± SD, mm179.45 ± 27.88185.44 ± 33.240.321
WBC, mean ± SD, 109/L2.89 ± 1.653.07 ± 1.850.596
Hb , mean ± SD, g/dL104.16 ± 26.9595.34 ± 28.141.000
PLT, mean ± SD, 109/L40.32 ± 7.7438.24 ± 9.180.214
TBIL, mean ± SD, μmol/L19.21 ± 9.7620.88 ± 12.660.454
AST, mean ± SD, U/L34.93 ± 21.2635.89 ± 15.080.779
ALT, mean ± SD, U/L31.14 ± 23.9129.41 ± 15.280.637
BUN, mean ± SD, mmol/L5.93 ± 2.255.38 ± 1.950.168
CER, mean ± SD, μmol/L72.32 ± 17.6371.15 ± 19.810.748
Table 2 Intraoperative and postoperative characteristics of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
VariableMLSD (n = 44)OSD (n = 71)P value
Operation time, median (range), min210 (140-390)180 (110-300)< 0.0001
Estimated blood loss, median (range), mL150 (50-800)300 (50-1200)< 0.0001
Blood transfused, median (range), mL0 (0-400)0 (0-700)0.024
VAS pain score on the first day, mean ± SD2.50 ± 0.855.06 ± 1.08< 0.0001
Time to first oral intake, mean ± SD, d1.52 ± 0.632.76 ± 0.62< 0.0001
Time to first flatus, mean ± SD, d2.36 ± 0.973.18 ± 1.000.0004
Time to off-bed activity, mean ± SD, d2.59 ± 0.695.96 ± 0.93< 0.0001
Postoperative hospital stay, median (range), d10 (7-18)15 (7-28)< 0.0001
Perioperative complications, n7260.017
Incision complications090.035
Incision hernia01
Superficial SSI05
Deep SSI03
Pneumonia030.436
Organ space SSI020.697
Emergency operation for bleeding030.436
Pancreatic fistula210.672
Asymptomatic portal vein thrombosis581.000
Table 3 Postoperative fever and white blood cell counts of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
VariableMLSD (n = 44)OSD (n = 71)P value
Postoperative fever, mean ± SD, d4.09 ± 3.166.89 ± 3.55< 0.0001
No fever, n720.029
WBC 0 d, mean ± SD, 109/L2.89 ± 1.653.07 ± 1.850.596
WBC 1 d, median (range), 109/L11.45 (5.2-17.4)16.9 (6.1-33.90)< 0.0001
WBC 3 d, mean ± SD, 109/L11.63 ± 3.2913.72 ± 4.670.011
WBC 7 d, median (range), 109/L8.4 (5-23.1)9.5 (4.9-38)0.035
Normal WBC, 1 d, n153< 0.0001
Normal WBC, 3 d, n14100.023
Normal WBC, 7 d, n36390.003
Table 4 Postoperative liver and renal functions of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
VariableMLSD (n = 44)OSD (n = 71)P value
AST 1 d, mean ± SD, U/L57.32 ± 27.8987.14 ± 135.130.152
AST 3 d, mean ± SD, U/L33.84 ± 22.1650.86 ± 43.830.018
AST 7 d, mean ± SD, U/L25.66 ± 11.2833.63 ± 16.320.005
ALT 1 d, mean ± SD, U/L40.14 ± 18.8161.66 ± 105.430.183
ALT 3 d, mean ± SD, U/L31.93 ± 25.2146.93 ± 56.600.100
ALT 7 d, mean ± SD, U/L21.14 ± 12.6329.68 ± 17.360.003
BUN 1 d, mean ± SD, mmol/L5.52 ± 1.766.54 ± 2.330.014
BUN 3 d, mean ± SD, mmol/L6.63 ± 2.207.33 ± 2.850.171
BUN 7 d, mean ± SD, mmol/L4.76 ± 2.025.52 ± 2.210.069
CER 1 d, mean ± SD, μmol/L75.27 ± 16.2284.99 ± 20.920.010
CER 3 d, mean ± SD, μmol/L59.75 ± 16.6466.04 ± 19.080.074
CER 7 d, mean ± SD, μmol/L60.88 ± 13.9260.83 ± 16.170.986
Table 5 Perioperative C-reactive protein, interleukin-6, and procalcitonin concentrations of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
VariableMLSD (n = 44)OSD (n = 71)P value
CRP day 0, median (range), mg/L1.03 (0.02-49.21)0.96 (0.03-13.32)0.715
CRP day 1, mean ± SD, mg/L28.39 ± 16.3036.86 ± 12.860.002
CRP day 3, mean ± SD, mg/L92.64 ± 53.16114.06 ± 44.370.022
CRP day 7, mean ± SD, mg/L41.14 ± 27.6152.49 ± 29.700.043
IL-6 day 0, mean ± SD, pg/mL6.14 ± 5.616.60 ± 7.260.715
IL-6 day 1, mean ± SD, pg/mL8.09 ± 6.9711.78 ± 9.180.024
IL-6 day 3, mean ± SD, pg/mL7.65 ± 6.9510.84 ± 8.420.037
IL-6 day 7, mean ± SD, pg/mL6.58 ± 5.669.83 ± 8.260.024
PCT day 0, mean ± SD, ng/mL0.45 ± 0.250.47 ± 0.270.722
PCT 1 d, median (range), ng/mL0.97 (0.36-3.2)1.96 (0.54-10.08)< 0.0001
PCT 3 d, median (range), ng/mL0.795 (0.3-2.67)1.45 (0.6-4.88)< 0.0001
PCT 7 d, median (range), ng/mL0.5 (0.28-4.01)0.77 (0.38-5.87)< 0.0001