Patients with liver cirrhosis frequently exhibit dyslipidemia due to impaired hepatic lipid synthesis, altered bile acid metabolism, and portal hypertension. Laparoscopic splenectomy is commonly used to treat splenomegaly and hypersplenism in these patients, but its impact on lipid profiles over 2 years remains poorly characterized. This study will follow patients undergoing laparoscopic splenectomy to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether laparoscopic splenectomy can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in cirrhotic patients.
Age 18-80 years, male or female
Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging)
Splenomegaly and hypersplenism
Child-Pugh Class A or B liver function
Child-Pugh Class C liver cirrhosis
No history of portal hypertension bleeding (esophageal and gastric variceal bleeding )
Previous abdominal surgery precluding safe laparoscopic splenectomy.
Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders
A 24-month (2-year) prospective, single-center, observational cohort study. Patients with liver cirrhosis and hypersplenism scheduled for elective laparoscopic splenectomy will be recruited and followed up for 2 years to evaluate dynamic changes in lipid profiles.
Cohort
Prospective
Not listed
Total cholesterol (TC) level
Change in total cholesterol (TC) level
Total triglycerides (TG) level
Change in total triglycerides (TG) level
High-density lipoprotein cholesterol (HDL-C) level
Change in high-density lipoprotein cholesterol (HDL-C)
Low-density lipoprotein cholesterol (LDL-C) level
Change in low-density lipoprotein cholesterol (LDL-C)
Intraoperative variables
operation time, intraoperative blood loss, fluid infusion, mean arterial pressure
Postoperative complications
postoperative complications (bleeding, infection, hepatic encephalopathy, ascites)
Albumin, bilirubin
Changes in albumin, bilirubin
Child-Pugh grade
Changes in Child-Pugh grade The Child-Pugh score is calculated based on five parameters, each assigned 1, 2, or 3 points. 1. Total bilirubin * Less than 2 mg/dL: 1 point * 2-3 mg/dL: 2 points * Greater than 3 mg/dL: 3 points 2. Serum albumin * Greater than 3.5 g/dL: 1 point * 2.8-3.5 g/dL: 2 points * Less than 2.8 g/dL: 3 points 3. Prothrombin time prolongation or INR * Prolongation less than 4 seconds (INR \< 1.7): 1 point * Prolongation 4-6 seconds (INR 1.7-2.3): 2 points * Prolongation greater than 6 seconds (INR \> 2.3): 3 points 4. Ascites * None: 1 point * Mild or controlled with diuretics: 2 points * Moderate to severe or refractory: 3 points 5. Hepatic encephalopathy * None: 1 point * Grade I-II: 2 points * Grade III-IV: 3 points Total score and corresponding grade * 5-6 points: Child-Pugh class A * 7-9 points: Child-Pugh class B * 10-15 points: Child-Pugh class C
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