title: Liver regeneration after splenectomy in patients with liver cirrhosis.
abstract: OBJECTIVE
  Splenectomy is a well-known procedure to improve thrombocytopenia and liver function in patients with liver cirrhosis (LC). However, the effect of splenectomy on liver regeneration remains unclear. The aim of this study is to investigate the effect of splenectomy on liver regeneration.
  
  
  METHODS
  Twenty patients with LC who underwent splenectomy were included in this study. Liver and splenic volumes were measured by a 3-D simulation imaging system. Liver volume (LV) and clinicopathological data were compared before and 6 months after splenectomy. Thereafter, patients were divided into two groups: the elevated LV group and the reduced LV group. Patient characteristics were compared between the two groups.
  
  
  RESULTS
  Postoperative LV was increased in 14 patients compared with the preoperative state. Thrombocytopenia, leukopenia, total bilirubin and prothrombin time were improved after splenectomy. In the elevated LV group, four patients exhibited improved Child-Pugh grades after splenectomy, whereas no patients demonstrated improvement in the reduced LV group. The elevated LV group exhibited high albumin level, good indocyanine green retention rate at 15 min and large splenic volume compared with the same measurements in the decreased group. Patients with larger spleen volumes and higher albumin values before splenectomy showed increased rates of LV after splenectomy.
  
  
  CONCLUSIONS
  Splenectomy for patients with LC improved pancytopenia and liver function. Especially, in patients with large spleen and high albumin levels, considerable increases in LV and improved liver function were observed.
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Iwahashi
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Teraoku
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima City, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
keywords: liver cirrhosis; liver regeneration; splenectomy