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目的：探讨完全腹腔镜下巨脾切除术治疗肝硬化性门静脉高压症所致脾肿大、脾功能亢进的可行性、安全性及临床价值。方法回顾性分析我院48例肝硬化门脉高压症患者行脾切除术的临床资料,根据手术方式的不同分为两组：腹腔镜组(32例),接受完全腹腔镜下脾切除术；开腹组(16例),接受传统开腹手术行脾切除术。比较两组患者手术时间、术中出血量、术后疼痛指数、肠功能恢复时间、并发症发生率及术后住院时间等。结果腹腔镜组成功完成手术29例,中转开腹3例。腹腔镜组与开腹组平均手术时间分别为(140依21)min和(132依18)min,两组比较差异无统计学意义(=2.301,=0.501)；术中平均出血量分别为(163依40)ml和(300依34)ml,两组相比差异有统计学意义(=1.157,=0.023)；术后平均住院时间分别为(7.2依1.6)d和(9.9依2.0)d,两组相比差异有统计学意义(=2.018,=0.001)；腹腔镜组术后并发症发生率、术后疼痛指数较开腹组低,术后肠功能恢复较开腹组快,两组相比差异有统计学意义(<0.05)。结论与传统开腹手术相比,完全腹腔镜下巨脾切除术创伤小、术中出血少,术后并发症发生率低、恢复快、住院时间短,在外科治疗门脉高压症所致的脾肿大、脾功能亢进是安全、可行、有效的,值得临床进一步推广。“,”Objective This study aimed to evaluate the operative technique, feasibility,ef ectiveness and safety of laparoscopic splenectomy for the treatment of portal hypertension in cir hotic patients. Methods Forty eight cirrhotic patients with portal hypertension underwent either total y laparoscopic or open splenectomy in our hospital between January 2013 and March 2015. According to the operation method,they were divided into Laparoscopic group (n=32) and Open group (n=16),perioperative and postoperative clinical parameters,such as operation time, bleeding during operation, postoperative pain score,postoperative complications and hospital stay were analyzed and compared. Results In the laparoscopic group the procedure was successful y performed in 29 patients,3 cases were converted to open surgery.The operative time in laparoscopic group and the open group were (140±21)min and(140±21)min respectively,( t=2.301,=0.501). The mean intro-operative blood loss was (163±40)ml and(300±34)ml respectively,(=1.157,=0.023). The post-operative stay was (7.2±1.6) and (9.9±2.0 )days respectively, (=2.018,=0.001). Dif erences between the two groups are statistical y significant. The post-operative complication rate and pain are bet er in the laparoscopic group. Conclusion Laparoscopic splenectomy is feasible,ef ective and safe for cir hotic patients with portal hypertension,it has the advantage of less intra-operative blood loss,reducing the operation trauma,less postoperative complications,improving postoperative recovery and shorter hospitalization than open surgery.