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Analysis of risk factors for massive intraoperative bleeding during laparoscopic splenectomy
Author(s) -
Ohta Masayuki,
Nishizaki Takashi,
Matsumoto Toshifumi,
Shimabukuro Rinshyun,
Sasaki Atsushi,
Shibata Kohei,
Matsusaka Toshimitsu,
Kitano Seigo
Publication year - 2005
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-005-1027-7
Subject(s) - medicine , splenectomy , cirrhosis , portal hypertension , univariate analysis , surgery , laparoscopy , multivariate analysis , logistic regression , hematologic disease , laparoscopic surgery , disease , spleen
Background/Purpose Laparoscopic splenectomy is occasionally converted to open surgery due to massive intraoperative bleeding. The aim of this study was to identify the risk factors for massive bleeding during laparoscopic splenectomy. Methods Fifty‐three patients underwent laparoscopic splenectomy. The indications were hematologic disease in 25 patients, liver cirrhosis in 17 patients, and other conditions in 11 patients. Univariate analysis was conducted with Fisher's exact test, and multivariate analysis was conducted with a stepwise logistic regression model. Results None of the patients required open surgery. Blood loss of more than 800 ml was defined as massive intraoperative bleeding. Univariate analysis showed significant risk factors for massive bleeding to be liver cirrhosis, portal hypertension, splenomegaly, Child class, and preoperative platelet count. Independent risk factors in the multivariate analysis were portal hypertension and Child class. Conclusions Careful attention to intraoperative bleeding during laparoscopic splenectomy is necessary for patients with portal hypertension and/or deteriorated liver function.