title: Hepatic vein waveform and splenomegaly predict improvement of prothrombin time after splenectomy in hepatitis C virus-related cirrhotic patients.
abstract: OBJECTIVE
  Whether hepatic function can recover in cirrhotic patients after splenectomy remains controversial.
  
  
  METHODS
  All consecutive Japanese patients with hepatic cirrhosis due to hepatitis C who had undergone elective splenectomy in Kyushu University Hospital between January 2008 and December 2009 were included in this retrospective study. Prothrombin time, serum albumin and total bilirubin concentrations were reviewed before and after splenectomy and analyzed to clarify whether splenectomy improves hepatic function in patients with cirrhosis and to determine the factors predictive of improvement in hepatic function.
  
  
  RESULTS
  Prothrombin time and total serum bilirubin concentration improved after splenectomy; however, serum albumin concentrations did not increase significantly. Twelve months after splenectomy, total serum bilirubin had decreased by over 0.3 mg/dL in 52.3% of patients and prothrombin time had improved by over 10% in 52.3% of patients. Multiple linear regression analysis identified hepatic vein waveform (HVWF) type I (P = 0.0174) and spleen weight (P = 0.0394) as independent predictors of improvement in prothrombin time and preoperative total serum bilirubin (P = 0.0002) as the only independent predictor of decrease in total bilirubin. Total bilirubin and prothrombin time were significantly improved after splenectomy in patients with HVWF type I, however, they were not improved in patients with HVWF type II.
  
  
  CONCLUSIONS
  Prothrombin time and total bilirubin improve in approximately half of cirrhotic patients within a year after splenectomy. HVWF type I and splenomegaly may be predictive factors for improvement in prothrombin time after splenectomy in patients with cirrhosis due to hepatitis C.
authors: Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
authors: Nao
authors: N
authors: Kinjo
authors: Yoshihiro
authors: Y
authors: Nagao
authors: Tomohiko
authors: T
authors: Akahoshi
authors: Kamori
authors: K
authors: Masahiro
authors: Naotaka
authors: N
authors: Hashimoto
authors: Hideo
authors: H
authors: Uehara
authors: Hirohumi
authors: H
authors: Kawanaka
authors: Morimasa
authors: M
authors: Tomikawa
authors: Ken
authors: K
authors: Shirabe
authors: Makoto
authors: M
authors: Hashizume
authors: Yoshihiko
authors: Y
authors: Maehara
keywords: hepatic cirrhosis; hepatic improvement; hepatic vein waveform; hepatitis C; splenectomy