Influencing factors of portal vein thrombosis after splenectomy in patients with portal hypertension

doi:10.3877/cma.j.issn.2095-3232.2015.05.007

Abstract

Abstract:

Objective

To investigate the influencing factors of portal vein thrombosis (PVT) after splenectomy in patients with portal hypertension.

Methods

Clinical data of 67 patients with liver cirrhosis and portal hypertension undergoing splenectomy + endoscopic variceal ligation in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between March 2012 and April 2015 were retrospectively studied. Among the 67 patients, 47 were males and 20 were females with the average age of (47±8) years old. Thirty-five patients underwent laparoscopic splenectomy and 32 patients underwent open splenectomy. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the PVT group and the non-PVT group according to whether PVT developed after surgery. The influencing factors of PVT in two groups were compared. The comparison of the influencing factors of PVT was conducted using t test or chi-square test.

Results

Eleven cases developed PVT after splenectomy with the incidence of 16% (11/67) including 6 cases of laparoscopic splenectomy and 5 of open splenectomy. The incidence of PVT was associated with Plt and the concentration of D-dimer in blood circulation. Blood Plt of the PVT group was (739±39) ×10⁹/L, which was significantly higher than (318±51)×10⁹/L of the non-PVT group (t=14.678, P<0.05). The concentration of D-dimer of the PVT group was (7.4±1.1) mg/L, which was significantly higher than (4.0±0.9) mg/L of the non-PVT group (t=5.458, P<0.05). The incidence of PVT was not associated with surgical procedure (χ²=0.028, P>0.05).

Conclusion

The incidence of PVT after splenectomy is associated with Plt and the concentration of D-dimer and is not associated with surgical procedure.

Key words: Splenectomy, Venous thrombosis, Hypertension, portal, Platelet count, D-dimer

Bo Liu, Zhicheng Yao, Kunpeng Hu, Jizong Lin, He Huang, Shilei Xu, Qingliang Wang, Peng Zhang, Peisheng Yang. Influencing factors of portal vein thrombosis after splenectomy in patients with portal hypertension[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(05): 284-287.

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References 20

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组别	性别（例）		年龄（岁，±s）	手术方式（例）		手术时间（min，±s）	住院时间（d，±s）	红细胞血液（U，±s）	新鲜冰冻血浆（ml，±s）
组别	男	女	年龄（岁，±s）	腹腔镜	开腹	手术时间（min，±s）	住院时间（d，±s）	红细胞血液（U，±s）	新鲜冰冻血浆（ml，±s）
PVT组	7	4	49±10	6	5	185±32	7.4±1.1	2.2±0.6	388±80
无PVT组	40	16	47±9	29	27	165±41	6.4±0.9	2.4±0.4	416±61
统计值	χ²=0.267		t=0.336	χ²=0.028		t=0.858	t=1.543	t=-0.620	t=-0.625
P值	>0.05		>0.05	>0.05		>0.05	>0.05	>0.05	>0.05
组别	冷沉淀（U，±s）	Plt（10⁹/L，±s）	PT（s，±s）	INR（±s）	血D-二聚体（mg/L，±s）	血纤维蛋白原（g/L，±s）	脾长径（cm，±s）	门静脉直径（cm，±s）
PVT组	14±5	739±39	14.1±1.4	1.2±0.3	7.4±1.1	2.38±0.31	18±4	1.3±0.4
无PVT组	13±5	318±51	15.2±1.7	1.3±0.2	4.0±0.9	2.51±0.24	19±4	1.1±0.6
统计值	t=0.330	t=14.678	t=-1.128	t=-0.707	t=5.458	t=-0.741	t=-415.000	t=0.642
P值	>0.05	<0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05

组别	性别（例）		年龄（岁，±s）	手术方式（例）		手术时间（min，±s）	住院时间（d，±s）	红细胞血液（U，±s）	新鲜冰冻血浆（ml，±s）
组别	男	女	年龄（岁，±s）	腹腔镜	开腹	手术时间（min，±s）	住院时间（d，±s）	红细胞血液（U，±s）	新鲜冰冻血浆（ml，±s）
PVT组	7	4	49±10	6	5	185±32	7.4±1.1	2.2±0.6	388±80
无PVT组	40	16	47±9	29	27	165±41	6.4±0.9	2.4±0.4	416±61
统计值	χ²=0.267		t=0.336	χ²=0.028		t=0.858	t=1.543	t=-0.620	t=-0.625
P值	>0.05		>0.05	>0.05		>0.05	>0.05	>0.05	>0.05
组别	冷沉淀（U，±s）	Plt（10⁹/L，±s）	PT（s，±s）	INR（±s）	血D-二聚体（mg/L，±s）	血纤维蛋白原（g/L，±s）	脾长径（cm，±s）	门静脉直径（cm，±s）
PVT组	14±5	739±39	14.1±1.4	1.2±0.3	7.4±1.1	2.38±0.31	18±4	1.3±0.4
无PVT组	13±5	318±51	15.2±1.7	1.3±0.2	4.0±0.9	2.51±0.24	19±4	1.1±0.6
统计值	t=0.330	t=14.678	t=-1.128	t=-0.707	t=5.458	t=-0.741	t=-415.000	t=0.642
P值	>0.05	<0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05

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