Postsplenectomy thrombosis of splenic, mesenteric, and portal vein (PST-SMPv): A single institutional series, comprehensive systematic review of a literature and suggested classification

Abstract

Objectives: No standard classification exists for post-splenectomy thrombosis of splenic, mesenteric, and portal vein (PST-SMPv). The goal of this study was to review our institution's experience with PST-SMPv and to perform a systematic literature review.

Methods: A retrospective review of all patients undergoing splenectomy from 1995-2016 at our institution was performed. Additionally, six databases and four grey literature websites were systematically searched. Splenectomy for pediatric patients or for trauma or portal hypertension related reasons were excluded.

Results: Between 1995 and 2016, 229 patients (113; 49.3% males) underwent splenectomy for spleen related diseases at our institution. From 1895 to 2016, 1645 unique literature citations were identified. Twenty citations met our inclusion criteria. Data on 1745 splenectomized patients was compiled; PST-SMPv occurred in 141 (8.1%).

Conclusions: In our series, PST-SMPv developed in 6.6% of patients and the incidence of PST-SMPv after splenectomy in the literature ranges from 0.8 - 53.0%. A call for standardized reporting through a proposed classification is made.

Keywords: Portal vein; Splenectomy; Splenic vein; Thrombosis classification; Vein thrombosis.