To compare the safety and feasibility of laparoscopic splenectomy and esophagogastric devascularization (LS+ ED) versus open splenectomy and esophagogastric devascularization (OS+ ED) in treating portal hypertension using Meta-analysis.

Controlled trials comparing LS+ ED and OS+ ED in treating portal hypertension were electronically searched from Wan Fang Data Knowledge Service Platform, Medalink, CNKI, PubMed, Elsevier, SpringerLink and CBM disc. The most recent search was conducted in April 2015. All the relevant data and references were retrieved and screened. RevMan 5.2 was used for data analysis.

Eventually, 7 randomized controlled trials (RCTs) or high-quality case-controlled studies involving 468 patients were included into this study. Meta-analysis showed LS reduced blood loss [WMD=214.67, 95%CI 198.74-230.60, P<0.01], shortened flatus time [WMD=17.72, 95%CI 12.39-23.04, P<0.01] and postoperative hospital stay [WMD=3.75, 95%CI 3.28-4.23, P<0.01], while the duration of surgery was shorter in OS (P>0.05). However, OS was comparable with LS in complication rates.

Comparing with OS, LS had the advantages of reducing intraoperative blood loss and shortening recovery time after operation. In patients with cirrhosis, portal hypertension and esophageal varices, laparoscopic splenectomy was safe and effective.

Portal hypertension; Liver cirrhosis; Laparoscopy; Splenectomy; Esophagogastric devascularization; Meta-analysis