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Purpose <p>To assess the safety and efficacy of combining laparoscopic hepatectomy (LH) with splenic artery ligation (SAL) for patients with hepatocellular carcinoma (HCC) and concomitant portal hypertension.</p> Methods <p>We conducted a multicenter, retrospective cohort analysis of 174 patients: 85 treated with LH + SAL (study group) and 89 treated with LH alone (control group). The key metrics evaluated included operative duration, blood loss, postoperative hospital stay, hematological parameters such as platelet count and white/red blood cell counts, immunological markers (CD4+/CD8 + ratio), complication rates, and survival outcomes. Statistical comparisons were made using t-tests, chi-squared tests, and Kaplan-Meier analysis. To mitigate potential biases and adjust for baseline characteristics, propensity score matching (PSM) was performed.</p> Results <p>The LH + SAL group had a significantly longer operative time (101.59 ± 12.51 vs. 92.73 ± 15.29&#xa0;min, <i>P</i> &lt; 0.05) but a shorter postoperative hospital stay (<i>P</i> &lt; 0.05). Hematological and immunological improvements were observed in the study group 1 week, 1 month, 3 months, and 6 months postoperatively, with higher platelet counts and CD4+/CD8 + ratios (<i>P</i> &lt; 0.05). Complication rates were comparable between the groups (<i>P</i> &gt; 0.05). Notably, the 3-year overall survival rate was significantly higher in the study group (<i>P</i> &lt; 0.001).</p> Conclusion <p>The integration of LH and SAL enhances hematological status and immune function safely, reduces hospitalization duration, and improves the long-term survival of HCC patients with portal hypertension, without increasing surgical risks.</p>

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Efficacy of combined laparoscopic hepatectomy and splenic artery ligation for hepatocellular carcinoma with portal hypertension

  • 期刊论文

  • 发表日期：

    2026年3月19日

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  • Song Xu,
  • Mengmeng Zhang,
  • Lingzhi Wang,
  • Zhongran Man,
  • Ming Xu

摘要

Purpose

To assess the safety and efficacy of combining laparoscopic hepatectomy (LH) with splenic artery ligation (SAL) for patients with hepatocellular carcinoma (HCC) and concomitant portal hypertension.

Methods

We conducted a multicenter, retrospective cohort analysis of 174 patients: 85 treated with LH + SAL (study group) and 89 treated with LH alone (control group). The key metrics evaluated included operative duration, blood loss, postoperative hospital stay, hematological parameters such as platelet count and white/red blood cell counts, immunological markers (CD4+/CD8 + ratio), complication rates, and survival outcomes. Statistical comparisons were made using t-tests, chi-squared tests, and Kaplan-Meier analysis. To mitigate potential biases and adjust for baseline characteristics, propensity score matching (PSM) was performed.

Results

The LH + SAL group had a significantly longer operative time (101.59 ± 12.51 vs. 92.73 ± 15.29 min, P < 0.05) but a shorter postoperative hospital stay (P < 0.05). Hematological and immunological improvements were observed in the study group 1 week, 1 month, 3 months, and 6 months postoperatively, with higher platelet counts and CD4+/CD8 + ratios (P < 0.05). Complication rates were comparable between the groups (P > 0.05). Notably, the 3-year overall survival rate was significantly higher in the study group (P < 0.001).

Conclusion

The integration of LH and SAL enhances hematological status and immune function safely, reduces hospitalization duration, and improves the long-term survival of HCC patients with portal hypertension, without increasing surgical risks.