H Hayashi1, T Beppu, K Okabe, T Masuda, H Okabe, H Baba. 1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Abstract
BACKGROUND: Partial splenic embolization (PSE) in patients with cirrhosis can achieve a prolonged increase in blood cell count. However, there is little information on the risk factors for complications after PSE for liver cirrhosis. METHODS: Seventy patients (41 men and 29 women) with cirrhosis-induced hypersplenism underwent PSE. Based on the Child-Pugh classification, 30, 35 and five patients had class A, B and C disease respectively. Risk factors for complications after PSE were examined retrospectively by logistic regression analysis. RESULTS: The mean splenic infarction rate was 77.1 per cent. Twelve patients (17 per cent) had complications following PSE. In univariable analysis, Child-Pugh class C, total bilirubin level of 1.4 mg/dl or more, serum albumin level of 2.8 g/dl or less and infarcted splenic volume of 540 ml or more were significantly associated with complications after PSE. In multivariable analysis, Child-Pugh class C (P = 0.012) and infarcted splenic volume of 540 ml or more (P = 0.031) were identified as risk factors, with an odds ratio of 22.92 and 5.01 respectively. CONCLUSION: Child-Pugh class C and a large splenic infarction volume are risk factors for complications after PSE for liver cirrhosis. 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: Partial splenic embolization (PSE) in patients with cirrhosis can achieve a prolonged increase in blood cell count. However, there is little information on the risk factors for complications after PSE for liver cirrhosis. METHODS: Seventy patients (41 men and 29 women) with cirrhosis-induced hypersplenism underwent PSE. Based on the Child-Pugh classification, 30, 35 and five patients had class A, B and C disease respectively. Risk factors for complications after PSE were examined retrospectively by logistic regression analysis. RESULTS: The mean splenic infarction rate was 77.1 per cent. Twelve patients (17 per cent) had complications following PSE. In univariable analysis, Child-Pugh class C, total bilirubin level of 1.4 mg/dl or more, serum albumin level of 2.8 g/dl or less and infarcted splenic volume of 540 ml or more were significantly associated with complications after PSE. In multivariable analysis, Child-Pugh class C (P = 0.012) and infarcted splenic volume of 540 ml or more (P = 0.031) were identified as risk factors, with an odds ratio of 22.92 and 5.01 respectively. CONCLUSION:Child-Pugh class C and a large splenic infarction volume are risk factors for complications after PSE for liver cirrhosis. 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Guilherme Lopes P Martins; Joao Paulo G Bernardes; Marcello S Rovella; Raphael G Andrade; Publio Cesar C Viana; Paulo Herman; Giovanni Guido Cerri; Marcos Roberto Menezes Journal: World J Gastroenterol Date: 2015-05-28 Impact factor: 5.742