title: Effective Prevention for Portal Venous System Thrombosis After Splenectomy: A Meta-Analysis.
abstract: OBJECTIVE
  Portal venous system thrombosis (PVST) is a common and potentially life-threatening complication of splenectomy for portal hypertension due to cirrhosis.
  
  
  METHODS
  A meta-analysis was conducted to study the necessity of pharmacologic prophylaxis of PVST after splenectomy and how to select the feasible treatment method. Articles were searched through the PubMed, EMBASE, Cochrane Library databases, and CNKI.
  
  
  RESULTS
  Overall, 404 articles were initially identified, and 11 of them were eligible. Among these selected articles, 7 articles were associated with the necessity of anticoagulation for prevention of PVST, while 5 were about the drug selection. We first demonstrated that the incidence of PVST after splenectomy was significantly lower in patients who received the preventive measures than in those who did not (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.13-0.39, P < .00001). Then, we compared the new-style treatment with the conventional treatment and found that patients with new therapy method had lower incidence of PVST than those who received conventional treatment (OR: 0.37, 95% CI: 0.27-0.51, P < .00001). Also, some studies (n = 4) reported that early and combination use of anticoagulation drugs can lead to better outcome for patients with splenectomy and devascularization.
  
  
  CONCLUSIONS
  Preventative use of anticoagulant drugs might decrease the incidence of PVST after splenectomy in patients with portal hypertension, new anticoagulant drugs such as low-molecular-weight heparin should be used, and early or combination use of anticoagulation drugs might lead to lower PVST incidence for patients.
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Yadong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Miao
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Jinzhao
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Deng
authors.affiliation: Department of Hepatic Biliary Pancreatic Surgery, People's Hospital of Zhengzhou University , Zhengzhou, China .
authors.forename: Huanzhou
authors.initials: H
authors.lastname: Xue
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications; D016017:Odds Ratio; D011169:Portal Vein; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D013156:Splenectomy; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: anticoagulation; cirrhosis; pharmacologic prophylaxis; portal hypertension; portal venous system thrombosis; splenectomy and devascularization