He specializes in minimally invasive laparoscopic surgical treatment of hepatobiliary and gastrointestinal surgery, and treatment of cirrhotic portal hypertension. He was the first to carry out minimally invasive laparoscopic surgery such as endoscopic ligature of esophageal varices in cirrhosis, endoscopic gastrostomy jejunal nutrition tube placement, laparoscopic splenectomy and laparoscopic combined with choledochoscopic common bile duct exploration in Zhongshan III Hospital. The pale, cold limbs, conscious fisherman Lao Li was rushed to Zhongshan Hospital Lingnan Hospital, after 2 days, he first sudden onset of vomiting blood, as much as a small basin, but also 3 consecutive poop like tar, and this is not his first attack, the past 2 years he had the same symptoms, but this time, the situation is much more serious. According to family members, Old Li has suffered from hepatitis B for more than 20 years, and used to love to drink, and can drink up to 1 pound a day. Combined with the results of the physical examination, Liu Bo, deputy chief physician of the hospital’s general surgery department, quickly came to the judgment that this is a typical cirrhotic portal hypertension patient, due to the rupture of the esophageal varices at the base of the stomach, haemorrhage occurred, the spleen is also so large that almost squeezed the abdominal cavity half of the position, must be operated immediately. Liu Bo performed a new “two-scope” procedure for Lao Li, namely laparoscopic splenectomy combined with gastroscopic esophageal varices ligation. The operation went smoothly, and on the second day after the operation, Lao Li was able to move around on the ground and was discharged from the hospital on the seventh day, and went back to fishing 2 months later. He was discharged from the hospital on the seventh day and returned to fishing 2 months later. At follow-up, he is in good condition with no further vomiting of blood or black stools. Rupture of portal hypertension is very dangerous. Portal hypertension in cirrhosis is very common in China, and can occur in about 1/3 of patients with cirrhosis. Because portal blood cannot flow back into the inferior vena cava through the liver smoothly, the portal vein pressure suddenly increases and can only enter the body circulation directly through abnormal traffic branches, thus gradually developing a series of symptoms such as dilated abdominal wall and esophageal veins, splenomegaly and hypersplenism, liver function loss and ascites. ”The most frightening thing about portal hypertension is the esophagogastric fundic varices, which are very dangerous once they rupture, and the bleeding is usually so much that it has to be filled with a washbasin.” Liu Bo said, cirrhosis portal hypertension often developed from chronic liver disease, the patient early that the spleen enlargement, but difficult to detect themselves. After esophageal varices, like earthworms, the pressure is very high, and under the stimulation of eating, weather changes and other triggers, it is very easy to rupture and bleed, bleeding generally without aura, and no pain, but its amount can be as much as one or two pots, all bright red blood. Due to the large amount of blood flowing into the intestinal tract, the patient soon has diarrhea and excretes tar-like black stools. ”The mortality rate of the first occurrence of vomiting blood in such patients is as high as 25%. In addition, because of their generally poor physical condition, heavy disease and poor coagulation, and the variceal vein pressure in the esophagogastric fundus is often very high, it is very difficult to stop bleeding, which can be said to be the main cause of death in patients with liver cirrhosis.” Liu Bo said. Minimally invasive treatment patients can go down the next day For the upper gastrointestinal hemorrhage caused by portal hypertension in cirrhosis, the aim of surgical treatment is to first consider hemostasis, followed by addressing splenomegaly and hypersplenism. At present, there are many clinical treatments available, such as pharmacological hemostasis, three-chamber diathermy tube compression, endoscopic treatment, bypass and dissection, but each method has its own limitations. Among them, “splenectomy + peripancreatic vascular dissection” is by far the most widely used treatment modality, and its efficacy is relatively satisfactory. However, this procedure is very invasive, with incisions often more than 10 centimeters long, slow recovery, and a high rate of complications. Born in a medical family, Liu Bo studied under his father, Liu Xunyang, and has been dedicated to the treatment of portal hypertension. Professor Liu Xunyang, a nationally renowned expert in portal hypertension, is now practicing at the Third Xiangya Hospital of Central South University and has been the first to carry out clinical and experimental research on endoscopic variceal ligation of esophageal varices in Asia since the 1990s, playing an important role in the popularization of this technology in China. Liu Bo followed his father to the stage and mastered the technique early, and in 2006, he was the first in China to publish a paper on “endoscopic esophageal variceal ligation combined with splenectomy”. The clinical treatment of portal hypertension has always been the specialty of the Third Hospital of Sun Yat-sen University, which performs hundreds of surgeries for various types of cirrhotic portal hypertension every year, ranking among the top in China in terms of quantity, type and quality of surgeries. In view of the drawbacks and limitations of traditional surgical methods, the expert team of the department has relentlessly sought for more ideal surgical methods and improved and innovated various minimally invasive procedures, such as “percutaneous gastric needle-type endoscopic guided fundic vein ligation”, “endoscopic intensive esophageal vein ligation combined with partial splenic embolization “etc. In 2011, the Department of General Surgery of Lingnan Hospital of Sun Yat-sen Group of Hospitals was established, and on the basis of the original technical advantages, Liu Bo took the lead in carrying out “laparoscopic giant splenectomy combined with endoscopic esophageal variceal ligation” to treat portal hypertension combined with upper gastrointestinal haemorrhage, which further simplified the operation steps, shortened the operation procedure, and reduced intraoperative bleeding. In addition, it greatly reduces the damage to the patient’s body, and the postoperative recovery is fast, and all patients can resume light work within a short time. According to Liu Bo, in the past, cirrhosis was mostly triggered by schistosomes, and quite a number of farmers were infected by working in the field, and after cirrhosis, their stomachs were distended, ascites, sudden vomiting of blood and high mortality, and the family lost their labor force at once. Now, the cause of cirrhosis has changed, mostly developed from hepatitis and drinking, many patients still do not pay enough attention. In fact, as long as timely treatment, the prognosis of patients are very good. “Patients with cirrhosis major vomiting treated with the ‘two mirrors’ combination can be on the floor the day after surgery, can be discharged after a week, and can resume light physical labor in a month. We are not only saving lives, but also hope that such patients will continue to work after they go home.” Liu Bo said.
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