title: Spleen enlargement after distal gastrectomy in patients without hepatitis.
abstract: OBJECTIVE
  Platelet count-to-spleen diameter ratio is reported to be the best non-invasive predictor of esophageal varices in cirrhotic patients. However, spleen enlargement is frequently detected during follow-up of patients after gastrectomy. Thus, we studied the relationship of the platelet count-to-spleen diameter ratio with the development of esophageal varices after distal gastrectomy in patients without liver cirrhosis or hepatitis.
  
  
  METHODS
  We retrospectively studied 64 patients who underwent distal gastrectomy. Their platelet counts, spleen diameters and platelet count-to-spleen diameter ratios were correlated with the occurrence rate of esophageal varices after the surgery.
  
  
  RESULTS
  Esophageal varices were not detected during the first 6 months after surgery; however, esophageal varices were detected in 2 patients (3%) at 12 months after surgery and their mean platelet count-to-spleen diameter ratio was 2,628 ± 409.
  
  
  CONCLUSIONS
  The platelet count-to-spleen diameter ratio is a useful parameter for non-invasive prediction of esophageal varices after distal gastrectomy. In addition, we suggest that the occurrence rate of esophageal varices increases beyond 6 months after distal gastrectomy and when the platelet count-to-spleen diameter ratio is less than approximately 2600 and thus, endoscopy should be performed to determine the presence of esophageal varices.
authors: Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
authors: Takatsugu
authors: T
authors: Oida
authors: Kenji
authors: K
authors: Mimatsu
authors: Hisao
authors: H
authors: Kano
authors: Atsushi
authors: A
authors: Kawasaki
authors: Youichi
authors: Y
authors: Kuboi
authors: Nobutada
authors: N
authors: Fukino
authors: Kazutoshi
authors: K
authors: Kida
authors: Sadao
authors: S
authors: Amano
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013163:Splenomegaly / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography