Guo-Qing Jiang1,2, Dou-Sheng Bai2, Ping Chen2, Jian-Jun Qian2, Sheng-Jie Jin2, Xue-Hao Wang1. 1. 1 Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China . 2. 2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
Abstract
BACKGROUND: Portal vein system thrombosis (PVST) is a frequent and potentially life-threatening complication after laparoscopic splenectomy (LS) in cirrhotic patients with hypersplenism. The mechanisms and risk factors of PVST are poorly understood. This study investigated risk factors for PVST following LS in cirrhotic patients with hypersplenism. MATERIALS AND METHODS: A total of 56 consecutive cirrhotic patients with hypersplenism who underwent successful LS between 2013 and 2014 were included in this retrospective study. Based on the absence or presence of postoperative PVST on postoperative day (POD) 7, the patients were divided into non-PVST and PVST groups. Demographic and preoperative factors were analyzed. RESULTS: PVST increased in size in 24 (42.9%) of 56 patients after LS on POD 7. Logistic multivariate regression showed that a portal vein diameter >13 mm (relative risk 35.796, 95% confidence interval 4.534-282.614, and P = .001) and age >50 years (relative risk 20.127, 95% confidence interval 3.598-112.578, and P = .001) were significant independent risk factors for PVST. The incidence of PVST after LS in the portal vein diameter >13 mm group was significantly higher than that in the portal vein diameter ≤13 mm group (P = .001). Similarly, the incidence of PVST after LS in the age >50 years group was significantly higher than that in the age ≤50 years group (P = .001). CONCLUSION: A portal vein diameter >13 mm and age >50 years are independent risk factors for PVST after LS in cirrhotic patients with hypersplenism due to portal hypertension.
BACKGROUND: Portal vein system thrombosis (PVST) is a frequent and potentially life-threatening complication after laparoscopic splenectomy (LS) in cirrhoticpatients with hypersplenism. The mechanisms and risk factors of PVST are poorly understood. This study investigated risk factors for PVST following LS in cirrhoticpatients with hypersplenism. MATERIALS AND METHODS: A total of 56 consecutive cirrhoticpatients with hypersplenism who underwent successful LS between 2013 and 2014 were included in this retrospective study. Based on the absence or presence of postoperative PVST on postoperative day (POD) 7, the patients were divided into non-PVST and PVST groups. Demographic and preoperative factors were analyzed. RESULTS:PVST increased in size in 24 (42.9%) of 56 patients after LS on POD 7. Logistic multivariate regression showed that a portal vein diameter >13 mm (relative risk 35.796, 95% confidence interval 4.534-282.614, and P = .001) and age >50 years (relative risk 20.127, 95% confidence interval 3.598-112.578, and P = .001) were significant independent risk factors for PVST. The incidence of PVST after LS in the portal vein diameter >13 mm group was significantly higher than that in the portal vein diameter ≤13 mm group (P = .001). Similarly, the incidence of PVST after LS in the age >50 years group was significantly higher than that in the age ≤50 years group (P = .001). CONCLUSION: A portal vein diameter >13 mm and age >50 years are independent risk factors for PVST after LS in cirrhoticpatients with hypersplenism due to portal hypertension.
Authors: Manal Abduljalil; Jean Saunders; Dearbhla Doherty; Marthinus Dicks; Catherine Maher; Brian Mehigan; Richard Flavin; Catherine M Flynn Journal: Ann Med Surg (Lond) Date: 2021-05-08