title: Subtotal splenectomy for splenomegaly in cirrhotic patients.
abstract: BACKGROUND
  In recent years, the spleen has become to be recognized as the "control center" of the immune-metabolic-endocrine network. However, It is controversial that splenomegaly due to portal hypertension is treated by subtotal splenectomy. The aim of this study was to evaluate the distribution of fibrous tissue, morphology of cells as well as splenic size, hemodynamics, hematological and immunological indexes in the residual spleen after subtotal splenectomy. This information may help finding the basis for the operation of subtotal splenectomy.
  
  
  METHODS
  Ten cases of splenomegaly due to portal hypertension were investigated. Two groups were created: Splenomegaly and Residual spleen. Control group was 10 cases of trauma-induced splenic rupture. Samples were sliced, and morphological changes were observed under light microscopy and electron microscopy. Indexes of splenic size, hemodynamics, hematology and immunology of the spleen were measured.
  
  
  RESULTS
  Under light microscopy, the number of collagen fibers and elastic fibers was increased, and the number of reticular fibers was decreased in the residual spleen and splenomegaly groups. Under electron microscopy, the ultrastructure of endothelial cells, lymphocytes, macrophages, and reticular cells in the residual spleen group were noticeably improved more than in the splenomegaly group. Flow volume in the residual spleen and portal vein decreased obviously, with number of platelet rising to normal, and there was no significant difference in the indexes of immunology.
  
  
  CONCLUSIONS
  After subtotal splenectomy, the residual spleen will not experience a high-pressure environment, and the fibrosis of splenic tissue and remodelling of corpuscular morphology will cease.
authors.affiliation: Center of General Surgery, The 89th Hospital of People's Liberation Army Weifang, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Chu
authors.affiliation: Department of Pathology, Weifang Medical University Weifang, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Center of General Surgery, The 89th Hospital of People's Liberation Army Weifang, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Center of General Surgery, The 89th Hospital of People's Liberation Army Weifang, China.
authors.forename: Yongbo
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Pathology, Weifang Medical University Weifang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Center of General Surgery, The 89th Hospital of People's Liberation Army Weifang, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Pathology, Weifang Medical University Weifang, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Electron Microscope, Weifang Medical University Weifang, China.
authors.forename: Shengming
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Center of General Surgery, The 89th Hospital of People's Liberation Army Weifang, China.
authors.forename: Xiaoji
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013154:Spleen / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000209:etiology / Q000601:surgery
keywords: Histopathology; cirrhosis; cytomorphology; fiber tissues; residual spleen