〈Case Reports〉Hepatocellular carcinoma accompanied by hypersplenism: five cases of simultaneous hepatectomy and laparoscopic splenectomy
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[Abstract] Background : We performed simultaneous hepatectomy and laparoscopic splenectomy in a patient with hepatocellular carcinoma accompaniedby a reduced platelet count caused by hypersplenism. Methods : We retrospectively studied 5 cases of hepatectomy performed immediately after laparoscopic splenectomy at our hospital after July 2006, and evaluated the intraoperative blood loss, need for transfusion during surgery, postoperativecomplications, and postoperative hospital stay. Hematological analysis included the white blood cell count (WBC), platelet count (Plt), serum alanine transaminase (ALT), total serum bilirubin (T-Bil), prothrombin time (PT)%, and serum albumin (Alb). Analysis was performed on postoperative days (POD) 7, 14, 30, and 60. Results : The results showed intraoperative thromblood loss of 891+523.2 ml (mean+ SD, 35-2, 199), blood transfusion in 3 cases (60%), no complications in all cases, and a postoperative hospital stay of 11.8 (11-13) days. Compared with preoperative levels, WBC and Plt were significantly higher on POD 7, 14, 30, and 60. while ALT and T-Bil were significantly lower on POD 30. Alb levels were low on all postoperative days compared with preoperative levels. There were no significant changes in PT%. Conclusions : It was safe to conduct hepatectomy simultaneously with laparoscopic splenectomy. No significant liver dysfunction occurred postoperatively, suggesting a potential reduction in the patient burden.
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