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. 2019 Apr 8:2019:5459427.
doi: 10.1155/2019/5459427. eCollection 2019.

The Effect of Splenectomy on the Reversal of Cirrhosis: a Prospective Study

Dao-Bing Zeng  1 , Liang Di  1 , Rui-Chi Zhang  2 , Qing-Liang Guo  1 , Bin-Wei Duan  1 , Cui-Yu Jia  2 , Feng Chen  2 , Dong-Dong Lin  1 , Yun-Jin Zang  1 , Shi-Chun Lu  3
Affiliations

The Effect of Splenectomy on the Reversal of Cirrhosis: a Prospective Study

Dao-Bing Zeng et al. Gastroenterol Res Pract. .

Abstract

Background: Studies have demonstrated that liver fibrosis can be reversed by medication treatments. After splenectomy, cirrhosis patients have short-term changes in several serum markers for cirrhosis and liver stiffness.

Aims: To investigate the effect of splenectomy on the severity of cirrhosis.

Methods: A total of 62 patients with cirrhosis and portal hypertension receiving splenectomy from December 2014 to July 2017 were enrolled. The degree of cirrhosis was preoperatively and postoperatively evaluated by serum markers, including hyaluronan (HA), laminin, amino-terminal propeptide of type III procollagen (PIIINP), type IV collagen (C-IV), liver stiffness (FibroScan), and liver volume.

Results: HA levels significantly increased at 1 week and 1 month postoperation (both P < 0.05), whereas the levels of PIIINP and C-IV significantly decreased from 1 month to 12 months postoperation (all P < 0.05). In addition, elastography examination demonstrated that the FibroScan score significantly reduced from 1 month to 24 months postoperation as compared with the baseline level (all P < 0.05). CT scan showed that the liver volume significantly increased at 6 months postoperation (P < 0.05). Furthermore, the alteration trends of these serum markers and the FibroScan score were further confirmed by the multivariate linear regression.

Conclusions: These observations suggested that splenectomy may result in long-term reversal of cirrhosis.

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Figures

Figure 1
Figure 1
The changes in patients' serum markers, including HA (a), LN (b), PIIINP (c), and C-IV (d). ∗P < 0.05 compared to preoperation. The numbers of compared pairs of all serum markers at 1 week, 1 month, 3 months, 6 months, and 12 months were 48, 39, 30, 27, and 15, respectively. The sample sizes of HA were 51, 50, 40, 32, 29, and 16 to preoperation, 1 week, 1 month, 3 months, 6 months, and 12 months, respectively. The sample sizes of LN were 51, 50, 40, 32, 29, and 16 to preoperation, 1 week, 1 month, 3 months, 6 months, and 12 months, respectively. The sample sizes of PIIINP were 51, 50, 40, 32, 29, and 16 to preoperation, 1 week, 1 month, 3 months, 6 months, and 12 months, respectively. The sample sizes of C-IV were 51, 50, 40, 32, 29, and 16 to preoperation, 1 week, 1 month, 3 months, 6 months, and 12 months, respectively.
Figure 2
Figure 2
The change of patients' FibroScan (a) and liver volume (b). ∗P < 0.05 compared to preoperation. The numbers of compared pairs of FibroScan at 1 month, 3 months, 6 months, 12 months, and 24 months were 45, 37, 30, 31, and 6, respectively. The numbers of compared pairs of liver volume at 1 month, 3 months, 6 months, 12 months, and 24 months were 37, 28, 28, 22, and 5, respectively. The sample sizes of FibroScan were 55, 48, 40, 34, 32, and 6 to preoperation, 1 month, 3 months, 6 months, 12 months, and 24 months, respectively. The sample sizes of liver volume were 50, 44, 36, 35, 30, and 6 to preoperation, 1 month, 3 months, 6 months, 12 months, and 24 months, respectively.
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