Postoperative Outcomes Following a Modified Method of Surgical Division of the Splenic Pedicle in 719 Patients During Splenectomy for Portal Hypertension: A 12-Year, Retrospective, Single-Center Study

Background: Portal hypertension associated with liver cirrhosis can be treated by splenectomy. During splenectomy, the gas-trosplenic and the splenorenal ligaments that form the hilar splenic pedicle can be surgically divided by sever-al approaches, with the aim to reduce portal vein thrombosis (PVT) and postoperative pancreatic fistula (PPF). This 12-year retrospective study from a single center aimed to evaluate postoperative outcomes following use of a modified method of surgical division of the splenic pedicle (MSDSP) in 719 patients who underwent sple-nectomy for portal hypertension (PH). Material/Methods: From January 2010 to December 2021, 719 consecutive cirrhotic patients with PH and splenomegaly under-went splenectomy in our department. According to different methods of surgical division of the splenic pedi-cle, patients were divided into a Control Group (n=349) and a Study Group (n=370). The characteristics of the patients, perioperative indicators, postoperative complications (PVT, PPF and abdominal hemorrhage) and fol-low-up data were compared between the 2 groups. Propensity score matching was conducted to adjust for dif-ferences in preoperative characteristics at a 1: 1 ratio, resulting in 260 patients in each group.Results: After PSM was conducted, intraoperative blood loss, PVT, PPF, and hospital stay were decreased significantly in the matched Study Group (all P<0.01). Both groups showed similar results concerning recurrent esophago-gastric variceal bleeding and overall survival during the follow-up period.Conclusions: Our MSDSP help to reduce postoperative complications and shorten hospital stay.