Background: The aim of this study was to compare laparoscopic vs. laparotomic surgery for the treatment of hypersplenism with gallstones.
Methods: Forty patients were treated with splenectomy and cholecystectomy using either totally laparoscopic surgery (laparoscopic group) or laparotomy (laparotomy group). The outcomes were duration of the surgery, intraoperative bleeding volume, postoperative complications, and number of postoperative hospitalization days.
Results: There was no difference in the duration of the surgery between both groups. No patient experienced intraoperative complications. There were postoperative pleural effusions (N.=3) and bleeding at the puncture site (N.=1) in laparoscopic group, and postoperative pleural effusions (N.=2), incision infection (N.=2) and peritoneal effusion (N.=1) in laparotomy group. The length of postoperative hospitalization was markedly shorter in laparoscopic group. The follow-up for 3 to 15 months after the surgery demonstrated that hypersplenism was corrected in all patients. All blood markers (white blood cells, platelets, and hemoglobin) recovered to normal levels. The portal vein thrombosis occurred in 6 patients of laparoscopic group and 5 patients of laparotomy group; this was controlled by oral administration of Warfarin and enteric coated Aspirin capsules.
Conclusions: Treatment efficacy is comparable between laparoscopic surgery and traditional laparotomy. Laparoscopic surgery is more advantageous because of smaller trauma, faster postoperative recovery, and minimal invasiveness.