Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;74(5):1773-1780.
doi: 10.1007/s13304-022-01236-2. Epub 2022 Jan 7.

Robotic-assisted versus laparoscopic approach of Bai-Jiang-style vagus nerve-preserving splenectomy and azygoportal disconnection

Dou-Sheng Bai #  1 , Sheng-Jie Jin #  1 , Xiao-Xing Xiang #  2 , Jian-Jun Qian  1 , Chi Zhang  1 , Bao-Huan Zhou  1 , Guo-Qing Jiang  3
Affiliations

Robotic-assisted versus laparoscopic approach of Bai-Jiang-style vagus nerve-preserving splenectomy and azygoportal disconnection

Dou-Sheng Bai et al. Updates Surg. 2022 Oct.

Abstract

Robotic surgery has been widely accepted in many kinds of surgical procedures. Little is known about clinical effects of robotic-assisted splenectomy and azygoportal disconnection (RSD) for gastroesophageal variceal bleeding and secondary hypersplenism owing to cirrhotic portal hypertension. The aim of this study was to evaluate whether RSD is feasible and safe for patients with cirrhotic portal hypertension and whether RSD is superior to laparoscopic splenectomy and azygoportal disconnection (LSD). We retrospectively investigated the clinical effects of 50 patients with cirrhosis who underwent vagus nerve-preserving RSD (n = 20) and LSD (n = 30) between September 2020 and October 2021. We compared patients' demographic, intraoperative, and perioperative variables. RSD and LSD were successful in all patients. Operative time did not differ significantly between the RSD group and LSD group (151.15 ± 21.78 min vs. 144.50 ± 24.30 min, P > 0.05), but intraoperative blood loss were significantly reduced in the RSD group (61.00 ± 34.93 mL vs. 105.00 ± 68.77 mL, P < 0.05). No statistically significant differences were found regarding intraoperative allogeneic transfusion rate, visual analog scale pain score on the postoperative first day, time to first oral intake, initial passage of flatus, initial off-bed activity, postoperative hospital stay, and overall perioperative complication rate (all P > 0.05). In conclusion, RSD is not only a technically feasible and safe procedure but it was associated with less blood loss than LSD for cirrhotic portal hypertension with gastroesophageal variceal bleeding and secondary hypersplenism. Registered at researchregistery.com: trial registration number is researchregistry7244, date of registration October 10, 2021, registered retrospectively.

Keywords: Azygoportal disconnection; Laparoscopy; Liver cirrhosis; Portal hypertension; Robotic; Splenectomy.

PubMed Disclaimer

References

    1. Luo HP, Zhang ZG, Long X et al (2020) Combined Laparoscopic splenectomy and esophagogastric devascularization versus open splenectomy and esophagogastric devascularization for portal hypertension due to liver cirrhosis. Curr Med Sci 40(1):117–122. https://doi.org/10.1007/s11596-020-2154-8 - DOI - PubMed
    1. Zheng S, Sun P, Liu X, Li G, Gong W, Liu J (2018) Efficacy and safety of laparoscopic splenectomy and esophagogastric devascularization for portal hypertension: a single-center experience. Medicine (Baltimore) 97(50):e13703. https://doi.org/10.1097/MD.0000000000013703 - DOI
    1. Jiang XZ, Zhao SY, Luo H et al (2009) Laparoscopic and open splenectomy and azygoportal disconnection for portal hypertension. World J Gastroenterol 15(27):3421–3425. https://doi.org/10.3748/wjg.15.3421 - DOI - PubMed - PMC
    1. Hao X, Dai K, He Y, Tao L, Yu H (2020) Laparoscopic splenectomy via the spleen bed in combination with selective esophagogastric devascularization for patients with cirrhotic portal hypertension: a single-institution experience. Wideochir Inne Tech Maloinwazyjne 15(3):462–468. https://doi.org/10.5114/wiitm.2019.89655 - DOI - PubMed
    1. Zhe C, Jian-wei L, Jian C et al (2013) Laparoscopic versus open splenectomy and esophagogastric devascularization for bleeding varices or severe hypersplenism: a comparative study. J Gastrointest Surg 17(4):654–659. https://doi.org/10.1007/s11605-013-2150-4 - DOI - PubMed

MeSH terms

LinkOut - more resources