Effect of LSD on Lipid Profiles Within 1 Year Postoperatively in Cirrhosis Patients With Portal Hypertension Bleeding

Effect of Laparoscopic Splenectomy and Azygoportal Disconnection on Lipid Profiles Within 1 Year Postoperatively n Cirrhosis Patients With Portal Hypertension Bleeding

Patients with liver cirrhosis frequently exhibit dyslipidemia due to impaired hepatic lipid synthesis, altered bile acid metabolism, and portal hypertension. Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) is commonly used to treat Cirrhosis with Portal Hypertension Bleeding in these patients, but its impact on lipid profiles within 1 year postoperatively remains poorly characterized. This study will follow patients undergoing LSD to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether LSD can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in cirrhotic patients.

This study is a single-center retrospective medical record analysis. Patients who had undergone laparoscopic splenectomy and azygoportal disconnection were screened and included in medical records. Preoperative baseline data, as well as laboratory and clinical data at 3, 6, 9, and 12 months postoperatively, were extracted from the medical records to analyze the dynamic trends of four serum lipid parameters (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol). Intraoperative indicators, postoperative complications, albumin, bilirubin, and changes in Child-Pugh liver function classification were also collected as secondary outcome measures for statistical analysis.

Inclusion Criteria:

1. Age 18-80 years, male or female
2. Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging)
3. Splenomegaly and hypersplenism
4. History of portal hypertension bleeding (esophageal and gastric variceal bleeding )
5. Child-Pugh Class A or B liver function
6. Ability to complete 12-month follow-up

Exclusion Criteria:

1. Child-Pugh Class C liver cirrhosis
2. Previous abdominal surgery precluding safe laparoscopic splenectomy and azygoportal disconnection
3. Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders
4. Metabolic/endocrine diseases: Familial hyperlipidemia; uncontrolled severe diabetes mellitus, thyroid dysfunction, nephrotic syndrome; use of lipid-lowering drugs, hormones, or other drugs affecting blood lipids within 1 month before surgery.
5. Infections/inflammatory diseases: Active hepatitis, severe infections, or autoimmune diseases.
6. Cirrhotic complications (hepatic encephalopathy, refractory ascites) within 1 month before surgery
7. Pregnancy or lactation
8. Poor compliance, inability to complete follow-up