RecruitingNot ApplicableNCT07462091

Vagus Nerve-guided Laparoscopic Splenectomy and Azygoportal Disconnection

Sponsor

Northern Jiangsu People's Hospital

Enrollment

15 participants

Start Date

Mar 25, 2026

Study Type

INTERVENTIONAL

Conditions

Cirrhosis Hypertension, Portal Hypersplenism

Summary

This study aimed to evaluate the effectiveness and safety of vagus nerve-guided laparoscopic splenectomy and azygoportal disconnection, and to assess its impact on postoperative digestive complications and quality of life.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

A clinical, radiological or histologic diagnosis of cirrhosis of any etiology
Splenomegaly with secondary hypersplenism
Bleeding portal hypertension
No evidence of portal vein system thrombosis by ultrasound evaluation and angio-CT
Informed consent to participate in the study

Exclusion Criteria11

Delayed gastric emptying
Diarrhea
Hepatocellular carcinoma or any other malignancy,
Hypercoagulable state other than the liver disease related
DRUGS- oral contraceptives, anticoagulation or anti-platelet drugs.
Child - Pugh C
Recent peptic ulcer disease
History of Hemorrhagic stroke
Pregnancy.
Uncontrolled Hypertension
Human immunodeficiency virus (HIV) infection

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Interventions

PROCEDUREVagus nerve-guided laparoscopic splenectomy and azygoportal disconnection

The vagus nerve-guided procedure was performed in the following order: (1) find the left crural diaphragm; (2) via the surface of the left crural diaphragm, blunt dissect the left lateral surface of the distal esophagus using Bipolar Forceps, and find posterior vagal trunk; (3) along posterior vagal trunk towards left lateral esoph-agogastric junction, find and protect gastric and celiac branches; (4) enter the lesser omental sac from the right crural diaphragm using Bipolar Forceps; (5) transect the left gastric artery and vein together using a linear vascular stapler; (6) blunt dissect the anterior surface of the distal esophagus using Bipolar Forceps, and find anterior vagal trunk; (7) along anterior vagal trunk towards right lateral esoph-agogastric junction, find and protect gastric and hepatic branches; and (8) blunt dissect the right lateral surface of the distal esophagus. The hepatogastric ligament was conserved.