title: Risk Factors for Portal Vein System Thrombosis After Laparoscopic Splenectomy in Cirrhotic Patients with Hypersplenism.
abstract: BACKGROUND
  Portal vein system thrombosis (PVST) is a frequent and potentially life-threatening complication after laparoscopic splenectomy (LS) in cirrhotic patients with hypersplenism. The mechanisms and risk factors of PVST are poorly understood. This study investigated risk factors for PVST following LS in cirrhotic patients with hypersplenism.
  
  
  METHODS
  A total of 56 consecutive cirrhotic patients with hypersplenism who underwent successful LS between 2013 and 2014 were included in this retrospective study. Based on the absence or presence of postoperative PVST on postoperative day (POD) 7, the patients were divided into non-PVST and PVST groups. Demographic and preoperative factors were analyzed.
  
  
  RESULTS
  PVST increased in size in 24 (42.9%) of 56 patients after LS on POD 7. Logistic multivariate regression showed that a portal vein diameter >13 mm (relative risk 35.796, 95% confidence interval 4.534-282.614, and P = .001) and age >50 years (relative risk 20.127, 95% confidence interval 3.598-112.578, and P = .001) were significant independent risk factors for PVST. The incidence of PVST after LS in the portal vein diameter >13 mm group was significantly higher than that in the portal vein diameter ≤13 mm group (P = .001). Similarly, the incidence of PVST after LS in the age >50 years group was significantly higher than that in the age ≤50 years group (P = .001).
  
  
  CONCLUSIONS
  A portal vein diameter >13 mm and age >50 years are independent risk factors for PVST after LS in cirrhotic patients with hypersplenism due to portal hypertension.
authors.affiliation: 1 Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .|2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Jiang
authors.affiliation: 2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Dou-Sheng
authors.initials: DS
authors.lastname: Bai
authors.affiliation: 2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: 2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Qian
authors.affiliation: 2 Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Jin
authors.affiliation: 1 Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Xue-Hao
authors.initials: XH
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000601:surgery*; D015994:Incidence; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000379:methods; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*