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. 2024 Feb;38(2):648-658.
doi: 10.1007/s00464-023-10566-0. Epub 2023 Nov 27.

Portal vein velocity predicts portal vein system thrombosis after splenectomy with esophagogastric devascularization

Jin-Lin Wang  1 , Jian Li  1 , Wen-Qiang Wang  1 , Xing Lv  1 , Rong-Hua Zhu  1 , Tong Yuan  1 , Zhi-Wei Zhang  2 , Er-Lei Zhang  3 , Zhi-Yong Huang  4
Affiliations

Portal vein velocity predicts portal vein system thrombosis after splenectomy with esophagogastric devascularization

Jin-Lin Wang et al. Surg Endosc. 2024 Feb.

Abstract

Background: Portal vein system thrombosis (PVST) is a potentially fatal complication after splenectomy with esophagogastric devascularization (SED) in cirrhotic patients with portal hypertension. However, the impact of portal vein velocity (PVV) on PVST after SED remains unclear. Therefore, this study aims to explore this issue.

Methods: Consecutive cirrhotic patients with portal hypertension who underwent SED at Tongji Hospital between January 2010 and June 2022 were enrolled. The patients were divided into two groups based on the presence or absence of PVST, which was assessed using ultrasound or computed tomography after the operation. PVV was measured by duplex Doppler ultrasound within one week before surgery. The independent risk factors for PVST were analyzed using univariate and multivariate logistic regression analysis. A nomogram based on these variables was developed and internally validated using 1000 bootstrap resamples.

Results: A total of 562 cirrhotic patients with portal hypertension who underwent SED were included, and PVST occurred in 185 patients (32.9%). Multivariate logistic regression analysis showed that PVV was the strongest independent risk factor for PVST. The incidence of PVST was significantly higher in patients with PVV ≤ 16.5 cm/s than in those with PVV > 16.5 cm/s (76.2% vs. 8.5%, p < 0.0001). The PVV-based nomogram was internally validated and showed good performance (optimism-corrected c-statistic = 0.907). Decision curve and clinical impact curve analyses indicated that the nomogram provided a high clinical benefit.

Conclusion: A nomogram based on PVV provided an excellent preoperative prediction of PVST after splenectomy with esophagogastric devascularization.

Keywords: Cirrhosis; Portal hypertension; Portal vein system thrombosis; Portal vein velocity; Splenectomy.

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References

    1. Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS (2021) Liver cirrhosis. Lancet 398:1359–1376. https://doi.org/10.1016/S0140-6736(21)01374-X - DOI - PubMed
    1. Lv Y, Fan D, Han G (2023) Transjugular intrahepatic portosystemic shunt for portal hypertension: 30 years experience from China. Liver Int 43:18–33. https://doi.org/10.1111/liv.15313 - DOI - PubMed
    1. de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Faculty BVII (2022) Baveno VII—renewing consensus in portal hypertension. J Hepatol 76:959–974. https://doi.org/10.1016/j.jhep.2021.12.022 - DOI - PubMed
    1. de Franchis R, Faculty BVI (2015) Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 63:743–752. https://doi.org/10.1016/j.jhep.2015.05.022 - DOI - PubMed
    1. European Association for the Study of the Liver (2016) EASL Clinical Practice Guidelines: liver transplantation. J Hepatol 64:433–485. https://doi.org/10.1016/j.jhep.2015.10.006 - DOI

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