title: Implementation of laparoscopic splenectomy in children and the incidence of portal vein thrombosis diagnosed by ultrasonography.
abstract: BACKGROUND
  The aim of this study is to evaluate if symptomatic or asymptomatic PVT, as diagnosed with ultrasonography (US), occurs more often in children after the introduction and implementation of LS compared to open splenectomy.
  
  
  METHODS
  A retrospective cohort of 76 splenectomized patients for benign hematological disease were analyzed, 24 after open splenectomy (OS) and 52 after LS.
  
  
  RESULTS
  In six of the OS and 40 after LS a postoperative US was obtained. In two patients after LS, a PVT was seen on US. Both patients were symptomatic and also underwent a laparoscopic cholecystectomy. The length of stay in the hospital was significantly shorter for LS (median 4.5 days, range 2-12) compared to OS (median 7 days, range 5-12), (P=.00). Median operation time of OS was 65 min (range 35-130 min) and of LS 170 min (range 85-275 min) (P=.00). There was no difference in postoperative complications.
  
  
  CONCLUSIONS
  The risk of developing a PVT after laparoscopic splenectomy seems low, and thus LS is not contraindicated in patients with benign hematological disease. When combining LS and laparoscopic cholecystectomy, prophylactic heparin might be considered.
authors.affiliation: Pediatric Surgical Centre Amsterdam, VUMC/Emma's Childrens Hospital AMC, Amsterdam, The Netherlands. Electronic address: m.w.oomen@amc.uva.nl.
authors.forename: Matthijs W N
authors.initials: MW
authors.lastname: Oomen
authors.forename: Roel
authors.initials: R
authors.lastname: Bakx
authors.forename: Minke
authors.initials: M
authors.lastname: van Minden
authors.forename: Rick R
authors.initials: RR
authors.lastname: van Rijn
authors.forename: Marjolein
authors.initials: M
authors.lastname: Peters
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D010976:Platelet Count; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D013156:Splenectomy / Q000379:methods*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants
keywords: Children; Laparoscopy; Portal vein thrombosis; Splenectomy; Ultrasonography