Observation on the effect of splenectomy plus pericardial devascularization in the treatment of cirrhotic portal hypertension
Objective To study the curative effect of splenectomy plus pericardial devascularization(SPD)on cirrhotic portal hypertension(PHT)and its influence on liver function,blood circulation,serum interleukin-6(IL-6)and tumor nec-rosis factor-α(TNF-α).Methods A total of 116 patients with cirrhotic PHT treated in the Department of Hepatobiliary and Pancreatic Surgery of Guigang People's Hospital from May 2020 to April 2024 were enrolled for retrospective analysis.According to different surgical methods,they were divided into study group(61 cases)and control group(55 cases).The study group were given laparoscopic SPD,while the control group were given open SPD.And then,liver functions,blood circulations,blood routines,and the levels of serum IL-6 and TNF-α before and after treatment were compared between the two groups,and postoperative complications were statistically analyzed.Results On the first day,there was no statistically significant difference in the drainage volume between the study group and the control group(P＞0.05),while the postopera-tive gastrointestinal recovery time,drainage tube removal time,surgical time,bleeding volume,and hospitalization time of the study group were all shorter than those in the control group(P＜0.05).Compared with those before treatment,the levels of total bilirubin(TBIL),alanine aminotransferase(ALT),and thrombin time(PT)in both groups decreased,but albumin(ALB)levels increased on one month after surgery,and the TBIL,ALT,PT levels in the study group were lower,while the ALB levels were higher(P＜0.05).After surgery,the venous diameter(VD)and blood flow(VF)of the portal vein and splenic vein decreased compared to those before surgery,while the flow velocity(VV)levels increased.In addition,the VD and VF in the study group were smaller,and the VV levels were higher(P＜0.05).After surgery,the levels of white blood cell count(WBC)and platelet count(PLT)increased compared to those before surgery,and the study group had higher levels than the control group(P＜0.05).The serum levels of 1L-6 and TNF-α in both groups decreased compared to those before surgery at 7 days and 1 month after surgery,and the decrease in the study group was greater than that in the control group(P＜0.05).The total incidence of postoperative complications in the control group was significantly higher than that in the study group(P＜0.05).Conclusion Compared with open SPD,laparoscopic SPD can reduce intraoperative blood loss and postoperative complications in patients with cirrhotic PHT,which is beneficial to improve liver functions and hemody-namics,and reduce 1L-6 and TNF-α levels.
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