Laparoscopic splenectomy by secondary pedicle division strategy:a highly cost-effective method

Background Laparoscopic splenectomy(LS)shows many advantages compared with open surgery except for the highcost.This study was aimed to recommend secondary pedicle division strategy as a method with high cost-effectiveness.Methods From January 2003 to June 2005,14 consecutive patients underwent laparoscopic splenectomy.The splenicpedicle was controlled by secondary pedicle division strategy in 8 cases and by Endo-GIA in the other 6 cases.Aretrospective study was carried out to evaluate the operative time,blood loss,time to diet,operative morbidity,postoperative stay,and operative cost.Results LS was performed successfully in a total of 14 cases.There was no significant difference between the twostrategies in operative time,blood loss,time to diet,operative morbidity and postoperative stay.The operative cost ofsecondary pedicle division strategy group(RMB 8354.38±752.10)was significantly lower than that of Endo-GIA group(RMB 11053.33±602.27)(P<0.01).Conclusions Laparoscopic splenectomy by secondary pedicle division strategy is a safe,effective and economicalprocedure with the value of popularization in developing countries.