title: Total splenic vein thrombosis after laparoscopic splenectomy: a possible candidate for treatment.
abstract: BACKGROUND
  Portal or splenic vein thrombosis (PSVT) is a common disorder after laparoscopic splenectomy (LS). Splenomegaly is a well-known risk factor for PSVT. However, no treatment strategy for PSVT has been established.
  
  
  METHODS
  Thirty-three consecutive patients who had undergone LS and postoperative imaging surveillance were examined. PSVT was classified according to the site of thrombosis. We evaluated patient background, operative factors, and clinical symptoms.
  
  
  RESULTS
  Spleen weight of patients with PSVT (n = 17, median 218 g) was greater than that of patients without PSVT (n = 16, median 101 g). Seven patients developed thrombosis involving the entire splenic vein (total splenic vein thrombosis), and 4 of them had clinical symptoms (fever >38 degrees C and/or abdominal pain). The incidence of clinical symptoms was significantly more frequent in patients with than without total SVT. Operation time, blood loss, and spleen weight were also significantly greater in patients with total SVT. Multiple logistic regression analysis demonstrated spleen weight was the strongest predictor of PSVT and total SVT.
  
  
  CONCLUSIONS
  Patients with total SVT have greater risk factors for PSVT and frequently have clinical symptoms. They are candidates for anticoagulation therapy.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan. mikeda@surg2.med.osaka-u.ac.jp
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yasui
authors.forename: Katsuki
authors.initials: K
authors.lastname: Danno
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Fujie
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kitani
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Seki
authors.forename: Taishi
authors.initials: T
authors.lastname: Hata
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Shingai
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikenaga
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D013156:Splenectomy / Q000009:adverse effects*; D013158:Splenic Diseases / Q000145:classification / Q000601:surgery; D013162:Splenic Vein / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*