Laparoscopic Splenectomy for the Elderly Liver Cirrhotic Patients With Hypersplenism: A Retrospective Comparable Study

• Published in: Medicine (Baltimore) Vol. 95; no. 10; p. e3012
• Main Authors: Wang, Mingjun, Wei, Ailin, Zhang, Zhaoda, Peng, Bing
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 01.03.2016
• Subjects: Adult; Age Distribution; Age Factors; Aged; China - epidemiology; Female; Follow-Up Studies; Humans; Hypersplenism - diagnosis; Hypersplenism - etiology; Hypersplenism - surgery; Incidence; Liver Cirrhosis - complications; Liver Cirrhosis - surgery; Male; Middle Aged; Observational Study; Operative Time; Postoperative Complications - epidemiology; Retrospective Studies; Splenectomy - methods; Tomography, X-Ray Computed; Treatment Outcome; China
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000003012

A growing body of evidence has supported the benefits of laparoscopic splenectomy (LS) for hypersplenism due to liver cirrhosis. With the increased proportion of elderly persons worldwide, it is necessary to investigate the risks and benefits of LS in elderly liver cirrhotic patients.From September 2003 to March 2012, LS and open splenectomy (OS) were performed for 21 (Group 1) and 19 (Group 3) patients, respectively, all of whom were 65 years of age and older; in addition, 39 patients who were <65 years old were treated with LS and referred to as Group 2. Data (i.e., demographic characteristics and preoperative, intraoperative, and postoperative information) were retrospectively collected. Between-group comparisons were performed for the above-mentioned data.Compared with the patients in Group 3, the patients in Group 1 required longer operative times, fewer transfusions, less intensive care, a shorter postoperative course, and a shorter time to the first oral intake, and they had less blood loss and fewer postoperative short-term complications. During the follow-up period, compared with the preoperative status, significant changes in hemoglobin, leukocyte, platelet, and albumin levels were observed in all groups, whereas changes in the total BILirubin (BIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels were inconspicuous.Patients >65 years of age with hypersplenism caused by liver cirrhosis can safely undergo LS.