Background: Laparoscopic splenectomy has become the gold-standard procedure for normal to moderately enlarged spleens. However, the safety of laparoscopic splenectomy for patients with portal hypertension remains controversial.
Patients and methods: This prospective study was conducted on 16 patients diagnosed with hypersplenism secondary to portal hypertension; 5 (31.25%) females &11 (68.75%) males. All patients had preoperative gastroscopy & laparoscopic splenectomy was done and follow up was for 6 months.
Results: Despite mean operative time was: 136.4± 5.6 which is higher if compared with open surgery; the mean blood loss was less (766.9±11.3) and postoperative (PO) hospital stay (days) was also less (4.7 ± 1.2). Conversion to laparotomy was 18.75%. No major complications except postoperative bleeding that was noticed in 25%, three of them needed re-do. There was improvement in esophageal varices grade I with P-value=0.003 & grade II with P-Value=0.005 on gastroscopy.
Conclusions: Although laparoscopic splenectomy is associated with longer operating time, it is a feasible, effective and safe procedure that offers advantages in terms of less blood loss, lower operative complications, shorter post hospital stay and better quality-of-life outcomes. With gaining experience and proper case selection; progressively larger spleens can be removed using laparoscopy.