Vagus Nerve-guided Laparoscopic Splenectomy and Azygoportal Disconnection for Cirrhosis with Portal Hypertension and Hypersplenism

What this Trial Is About

Researchers are evaluating the effectiveness and safety of a surgical procedure called vagus nerve-guided laparoscopic splenectomy and azygoportal disconnection in patients with liver cirrhosis, gastroesophageal variceal bleeding, and secondary hypersplenism due to cirrhotic portal hypertension. The study aims to understand how this procedure affects postoperative digestive complications and the quality of life for these patients. All enrolled patients will undergo the vagus nerve-guided laparoscopic splenectomy and azygoportal disconnection procedure, which involves careful dissection to preserve specific nerve branches while removing the spleen and disconnecting certain blood vessels. After surgery, patients will receive specific medications including oral Apixaban twice daily for 6 months, subcutaneous low-molecular-weight heparin for 5 days, and oral dipyridamole three times daily for 3 months. At 3 months post-operation, an electron gastroscopy exam will check for delayed gastric emptying. Participants will be closely monitored for digestive complications such as diarrhea, bloating, nausea, and vomiting at 7 days and 3 months after surgery. Liver and kidney function tests, as well as body weight, will also be tracked. The main outcomes measured include the incidence of postoperative diarrhea and delayed gastric emptying at 3 months. Additional outcomes include digestive complications, variceal re-bleeding, changes in body weight, and liver and kidney function markers. The total follow-up period is at least 3 months after the operation.

Vagus Nerve-guided Laparoscopic Splenectomy and Azygoportal Disconnection