title: [Peri-operative treatment for hepatocellular carcinoma patients complied with cirrhosis and hypersplenism].
abstract: OBJECTIVE
  To investigate the influence of combined hepatectomy with splenectomy on safety of operation for hepatocellular carcinoma patients complied with cirrhosis and hypersplenism and the best peri-operative treatment of these patients.
  
  
  METHODS
  Clinical data of 177 hepatocellular carcinoma patients complied with cirrhosis and hypersplenism admitted from January 1999 to December 2009 were analyzed retrospectively. Among which, 71 patients received concomitant splenectomy with hepatectomy (splenectomy group), 106 patients only receive a hepatectomy (non-splenectomy group). The safety of operation, complications, liver function and WBC and PLT counts were compared between the two groups.
  
  
  RESULTS
  There was no significant difference of general conditions, counts of WBC and PLT between the two groups before operation. The counts of PLT at 1, 10, 30 day after operation were (88.4 ± 23.6) × 10⁹/L, (345.3 ± 98.2) × 10⁹/L and (210.8 ± 92.2) × 10⁹/L respectively in splenectomy group, which were significantly higher than that of non-splenectomy group (P < 0.05). The operation time of splenectomy group was (216 ± 105) min, which was longer than that of non splenectomy group (P < 0.05), but the blood loss and transfusion rate had not significantly difference between the two groups. The complication rates of splenectomy group and non-splenectomy group were 11.3% and 6.6% respectively, there was no significant difference between the two groups.
  
  
  CONCLUSIONS
  Combined hepatectomy with splenectomy will be safe for hepatocellular carcinoma patients complied with cirrhosis and hypersplenism as if the operative indication and increase the ability of peri-operative treatment are strictly obeyed.
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Science, Beijing 100021, China.
authors.forename: Xin-yu
authors.initials: XY
authors.lastname: Bi
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Zhao
authors.forename: Tao
authors.initials: T
authors.lastname: Yan
authors.forename: Cong
authors.initials: C
authors.lastname: Li
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Zhou
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.forename: Jian-qiang
authors.initials: JQ
authors.lastname: Cai
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome