Related Experiment Video

Updated: Jul 18, 2025

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

240

Risk Factors for a High Comprehensive Complication Index after Splenectomy Plus Pericardial Devascularization for

Yafei Zhang1, Hongwei Lu2, Hong Ji2

  • 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology
|August 21, 2023
PubMed

Insights

The comprehensive complication index (CCI) offers a superior method for assessing patient morbidity following portal hypertension surgery compared to the Clavien-Dindo classification. Simplified pericardial devascularization surgery shows better outcomes in reducing the cumulative complication index.

Area of Science:

  • Surgical outcomes and patient morbidity assessment.
  • Medical informatics and data analysis in surgery.

Background:

  • The Clavien-Dindo classification is a standard for grading surgical complications.
  • A novel Comprehensive Complication Index (CCI) integrates all complications into a single numerical score.
  • Evaluating the CCI's utility in portal hypertension surgery is crucial for refining morbidity assessment.

Purpose of the Study:

  • To compare the Comprehensive Complication Index (CCI) with the Clavien-Dindo classification in assessing postoperative morbidity.
  • To evaluate the correlation of CCI and Clavien-Dindo classification with postoperative hospital stay and expenses.
  • To analyze the effectiveness of different surgical approaches using the cumulative sum-CCI.

Main Methods:

  • Retrospective analysis of patients undergoing splenectomy with either simplified or traditional pericardial devascularization.
  • Correlation and logistic regression analyses to compare CCI and Clavien-Dindo classification regarding hospital stay and expenses.
  • Generation and comparison of cumulative sum-CCI graphs between surgical techniques.

Main Results:

  • Child-Pugh classification, spleen thickness, and blood loss were identified as risk factors for a high CCI.
  • CCI demonstrated a stronger correlation with postoperative hospital stay and total expenses than the Clavien-Dindo classification (R2=0.15 vs 0.14 for hospital stay).
  • The cumulative sum-CCI showed a more significant dynamic decrease for splenectomy plus simplified pericardial devascularization compared to the traditional approach.

Conclusions:

  • The Comprehensive Complication Index (CCI) is an effective tool for evaluating postoperative morbidity in portal hypertension patients.
  • The cumulative sum-CCI chart provides a valuable method for dynamic monitoring and comparison of surgical procedures.
  • Splenectomy plus simplified pericardial devascularization appears superior to the traditional method in reducing the cumulative complication index.
Abstract

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