title: Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension.
abstract: BACKGROUND
  Portal venous thrombosis (PVT) is a potentially fatal complication following splenectomy. Its mechanisms and risk factors are poorly understood, especially in patients with cirrhosis and portal hypertension. This study investigated risk factors for PVT following splenectomy in such patients.
  
  
  METHODS
  All consecutive patients with cirrhosis who underwent splenectomy in Kyushu University Hospital between 1998 and 2004 were included in this retrospective study. They were divided into two groups based on the presence or absence of postoperative PVT. Preoperative and operative factors were compared, and the relationships between formation of PVT and its independent variables were analysed. In some cases, portal venous flow was measured before and after splenectomy using duplex Doppler ultrasonography.
  
  
  RESULTS
  PVT developed after surgery in 17 (24 per cent) of 70 patients studied. Multivariable analysis showed that increased splenic vein diameter and low white cell count were significant independent risk factors for PVT. Portal venous flow after splenectomy was greatly reduced in the PVT group, but not in patients without PVT.
  
  
  CONCLUSIONS
  Large splenic vein diameter and low white cell count are independent risk factors for PVT after splenectomy in patients with cirrhosis and portal hypertension.
authors.affiliation: Department of Surgery and Science, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kinjo
authors.forename: H
authors.initials: H
authors.lastname: Kawanaka
authors.forename: T
authors.initials: T
authors.lastname: Akahoshi
authors.forename: M
authors.initials: M
authors.lastname: Tomikawa
authors.forename: N
authors.initials: N
authors.lastname: Yamashita
authors.forename: K
authors.initials: K
authors.lastname: Konishi
authors.forename: K
authors.initials: K
authors.lastname: Tanoue
authors.forename: K
authors.initials: K
authors.lastname: Shirabe
authors.forename: M
authors.initials: M
authors.lastname: Hashizume
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008102:Liver Circulation / Q000502:physiology; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects*; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*