Era of liver transplantation: combined anatomic splenectomy and anticoagulant therapy in prevention of portal vein thrombosis after splenectomy.
OBJECTIVE
Portal vein thrombosis (PVT) is a common complication following splenectomy in patients with liver cirrhosis and portal hypertension, which also brings difficulties to future possible liver transplantation. This paper retrospectively analyzes the preventive effect of combined anatomic splenectomy and early anticoagulant therapy on post-splenectomy portal vein thrombosis in patients with portal hypertension.


METHODS
We retrospectively analyzed 136 patients who underwent splenectomy at our hospital between January 2010 and December 2013 due to liver cirrhosis and portal hypertension. Patient conditions, such as coagulation function, splenic and portal vein thrombosis, intra-abdominal hemorrhage, pancreatic leakage and intra-abdominal infections, are observed postoperatively.


RESULTS
Despite the presence of liver cirrhosis and portal hypertension in patients, early postoperative anticoagulant therapy has no significant impact on coagulation function and intra-abdominal hemorrhage of these patients (p > 0.05). Anatomic splenectomy can reduce the occurrence of complications such as postoperative bleeding, pancreatic leakage and intra-abdominal infections (p < 0.05).


CONCLUSIONS
Combined anatomic splenectomy and early postoperative anticoagulant therapy can reduce post-splenectomy portal vein thrombosis in patients with portal hypertension, and is conducive to the future liver transplantation therapy may be needed by the patients.
Chen
C
Hongwei
Liang
L
Zhang
Li
L
Maoping
Zhang
Z
Yong
Du
D
Chengyou
Li
L
Dewei
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants