Post-gastrectomy spleen enlargement and esophageal varices: distal vs total gastrectomy.
OBJECTIVE
To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esophageal varices (EVs) development in patients without liver cirrhosis or hepatitis.


METHODS
We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-to-spleen diameter ratios were compared between the 2 groups.


RESULTS
EVs were not detected during the first 6 mo after surgery in either group; however, at 12 mo after surgery, EVs were detected in 2 patients (3%) in the DG group and in 1 patient (3.6%) in the TG group; their mean platelet count-to-spleen diameter ratio was 2628 +/- 409, and 2604 +/- 360, respectively.


CONCLUSIONS
Endoscopy should be performed to detect EVs when the platelet count-to-spleen diameter ratio is < 2600.
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp
Takatsugu
T
Oida
Kenji
K
Mimatsu
Hisao
H
Kano
Atsushi
A
Kawasaki
Youichi
Y
Kuboi
Nobutada
N
Fukino
Sadao
S
Amano
D000368:Aged; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000097:blood* / Q000209:etiology* / Q000473:pathology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D013163:Splenomegaly / Q000209:etiology*