title: Effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular carcinoma.
abstract: OBJECTIVE
  To study the effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular carcinoma.
  
  
  METHODS
  Twenty-six patients with HCC associated with cirrhosis were divided into hepatectomy with splenectomy group (splenectomy group, n=11) and hepatectomy without splenectomy group (non-splenectomy group, n=15). T lymphocyte subsets such as CD4, CD8, CD4/CD8, helper T (Th) lymphocyte cytokines such as interferon gamma (IFN-gamma), interleukin 2 (IL-2), interleukin 10 (IL-10) and white blood cell (WBC), platelet (PLT), total bilirubin (T-Bil) were measured and used as parameters to evaluate the effects of splenectomy.
  
  
  RESULTS
  There was no significant difference in CD4, CD8, CD4/CD8, IL2, IFN-gamma, IL10, WBC, PLT, T-Bil levels between two groups before surgery. Two months after operation, the levels of CD4 (41.2%+/-4.2% vs 34.7%+/-3.8%), CD4/CD8 (1.7+/-0.2 vs 1.0+/-0.2), IFN-gamma (102.3+/-15.9 pg/ml vs 86.5+/-14.8 pg/ml), IL-2(97.2+/-15.6 pg/ml vs 77.6+/-14.5 pg/ml) were increased and those of CD8 (25.6+/-3.9 vs 32.8%+/-4.1%), IL-10 (56.9+/-10.4 pg/ml vs 72.6+/-15.3 pg/ml) were decreased in splenectomy groups as compared with those in non-splenectomy group (P<0.05). WBC and PLT counts in the splenectomy group were 8.9+/-1.6 X 10(9) and 310+/-32 X 10(9), respectively, which were significantly higher than those in non-splenectomy group (3.7+/-1.4 X 10(9) and 104+/-41 X 10(9)) respectively on the 14th post-operative day. T-Bil concentration in the splenectomy group (24+/-7 micromol/L) was significantly lower than that in the non-splenectomy group (37+/-13 micromol/L) on the 7th post-operative day (P<0.05).
  
  
  CONCLUSIONS
  Splenectomy combined with hepatectomy for HCC associated with cirrhosis is helpful for the recovery of T-lymphocyte subsets and the maintenance of Th1/Th2 cytokine balance.
authors: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
authors: Zhi-Xin
authors: ZX
authors: Cao
authors: Xiao-Ping
authors: XP
authors: Chen
authors: Zai-De
authors: ZD
authors: Wu
mesh_terms: D000328:Adult; D016516:CD4-CD8 Ratio; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D016207:Cytokines / Q000097:blood; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013156:Splenectomy; D013921:Thrombocytopenia / Q000209:etiology / Q000601:surgery*
chemical_list: D016207:Cytokines