title: Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension.
abstract: OBJECTIVE
  We have compared the influences of three surgical strategies on the occurrence and development of portal vein thrombosis (PVT) in patients with liver cirrhosis complicated by portal hypertension (PHT) in this study.
  
  
  METHODS
  Total 116 patients who respectively underwent pericardial devascularization (PCDV) with splenectomy (PDS group: n = 50), selective PCDV (SPD group: n = 28) and splenorenal shunt (SRS) combined with PCDV (combined group: n = 38) were investigated in this study. The incidence of PVT before and after operation was monitored. The incidence of Grade II-IV PVT was used to assess the severity of PVT. The liver function was assessed according to the Child-Pugh classification.
  
  
  RESULTS
  The incidence and severity of PVT and live function were similar among the three groups before operation (P > 0.05). The incidence of PVT was significantly increased after surgery in each group (P < 0.001), but recovered to the baseline level at six months in combined group (P = 0.629). Besides, the severity of PVT was significantly aggravated in PDS (P < 0.001) and SPD (P = 0.026) groups after operation, but not in combined group (P = 0.525). Patients in combined group showed significantly lower incidence and severity of PVT than those in the other two groups at each follow-up time point (P < 0.05). In addition, the liver function in the combined group was significantly improved compared with the other two groups.
  
  
  CONCLUSIONS
  SRS combined with PCDV is superior to PCDV with splenectomy and selective PCDV for PHT in liver cirrhotic patients in inhibiting the occurrence and development of postoperative PVT and improving liver function.
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
authors.forename: Longci
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China. Electronic address: renjixuqing@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xu
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D015994:Incidence; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology
keywords: Cirrhosis; Portal hypertension; Selective pericardial devascularization; Splenorenal shunt; Thrombosis