关键词: 开腹脾切除, 腹腔镜脾切除, 贲门周围血管离断术, 肝硬化门静脉高压, 临床效果

Abstract: Objective To compare the clinical effect of laparoscopic splenectomy and open surgery combined with pericardial devascularization in the treatment of portal hypertension.
Methods From May 2016 to March 2019，100 cirrhotic patients with portal hypertension were randomly divided into control group and observation group（50 cases each）.Patients in the observation group were treated with laparoscopic splenectomy and pericardial devascularization.The perioperative indexes，blood routine，liver function，adverse reactions and the degree of gastric varices were compared between the two groups.
Results The operative time，postoperative hospital stay，postoperative blood loss and abdominal drainage tube placement time of the observation group were statistically significant compared with the control group（P<0.05）.Platelets and white blood cells in the observation group were higher than those in the control group，and the difference was statistically significant（P<0.05）.AST and ALT in the observation group were higher than those in the control group，the score of Child-Pugh which was lower than and the control group，the difference were both statistically significant（P<0.05）.The postoperative complications in the observation group were lower than those in the control group within 2 weeks after operation，and the postoperative improvement degree of gastric varices was better than that in the control group，with statistically significant difference（P<0.05）.
Conclusion Laparoscopic splenectomy combined with pericardial devascularization can effectively reduce the impact on liver function，shorten the postoperative recovery period and reduce the incidence of postoperative complications.

Key words: open splenectomy, laparoscopic splenectomy, pericardial devascularization, cirrhosis and portal hypertension, clinical effect