Portal and splenic venous thrombosis after splenectomy in patients with hypersplenism

Abstract

Background/aims: Portal and splenic venous thrombosis (PSVT) is not a rare complication of splenectomy. We report a retrospective study of PSVT after splenectomy in patients with liver cirrhosis and clarify the risk factors and discuss the necessity of preventive pharmacotherapy.

Methodology: Potential subjects comprised 27 patients who underwent splenectomy (including laparoscopic splenectomy) at our hospital between January 2003 and December 2005 for hypersplenism due to liver cirrhosis. Perioperative data were assessed for 17 patients who did not have portal tumor thrombus and followed-up regularly.

Results: PSVT occurred in 5 of the 17 patients (29%), none of them were symptomatic throughout follow-up. PSVT disappeared spontaneously in 2 of the 5 patients (40%) without any treatment. Patients with PSVT showed significant differences in comparison with patients without PSVT in age, preoperative platelet count, intraoperative bleeding,splenic weight and platelet-associated immunoglobulin G (PAIgG), CONCLUSIONS: PSVT occured at a high rate in patients after splenectomy, but at a lower than in patients with hematopathies. According to our results, thrombolytic agent may be required only when patients show symptoms of PSVT. Preoperative serum PAIgG level may represent worthwhile markers for predicting PSVT.