title: Effects of splenectomy on liver volume and prognosis of cirrhosis in patients with esophageal varices.
abstract: BACKGROUND
  Several previous studies have shown that hepatic regeneration after partial hepatic resection accelerates over time once a splenectomy has been performed. This was a retrospective study investigating whether a splenectomy has some beneficial effects for cirrhotic patients with esophageal varices.
  
  
  METHODS
  Ninety-three patients underwent either esophageal transection, including splenectomy (splenectomy group), or endoscopic injection sclerotherapy (controls) for esophageal varices. No patient had hepatocellular carcinoma and the grades of their hepatic function were from mild to moderate. The changes in hepatic and splenic functions and liver volume were evaluated, as well as the probability of survival.
  
  
  CONCLUSIONS
  Both plasma white blood cell and platelet counts significantly increased in the splenectomy group compared to the controls (P < 0.05). The proportion of liver volume 1 year after the treatments compared to the volume before the treatments (which was 100%) was 96.4% in splenectomy group and 94.4% in controls. No patient had serious complications, such as severe infection caused by the splenectomy. The two groups showed no statistically significant differences in survival rates throughout this study. Although hypersplenism significantly was improved by splenectomy, no difference in changes in liver volume nor survival probability between the two groups was found. Further studies, such as those with a large number of patients, long-term volumetric analysis, or histopathological examination, are needed to clarify fully the effects of splenectomy on cirrhotic patients.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, japan. mtomikaw!surg2.med.kyushu-u.ac.jp
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Rinshun
authors.initials: R
authors.lastname: Shimabukuro
authors.forename: Norikazu
authors.initials: N
authors.lastname: Gotoh
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohta
authors.forename: Keizo
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D000328:Adult; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D015911:Sclerotherapy; D013156:Splenectomy; D016019:Survival Analysis