Open AccessRisk Factors and Anticoagulation Effects of Portal Vein System Thrombosis After Laparoscopic Splenectomy in Patients With or Without Cirrhosis
Author(s) -
Hongkuan Deng,
Meng Hua Tao,
Li Cao,
Xiaojun Wang,
Shi Zheng,
Yong Cao
Publication year - 2019
Publication title -
surgical laparoscopy endoscopy and percutaneous techniques/surgical laparoscopy, endoscopy and percutaneous techniques
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.528
H-Index - 62
eISSN - 1534-4908
pISSN - 1530-4515
DOI - 10.1097/sle.0000000000000710
Subject(s) - medicine , cirrhosis , splenectomy , incidence (geometry) , portal vein thrombosis , surgery , thrombosis , logistic regression , risk factor , platelet , gastroenterology , spleen , physics , optics
The clinical data of 149 patients who underwent successful laparoscopic splenectomy (LS) between January 2014 and September 2017 were analyzed in the present study. The incidence of portal vein system thrombosis (PVST) in patients with and without cirrhosis was 32.0% and 9.5%, respectively. Multiple logistic regression analysis revealed that the ratio of the postoperative maximum platelet (PLT) count to the preoperative PLT count (r=1.144; P=0.007) was the risk factor for PVST in all patients after LS. Of patients who received prophylactic anticoagulation, 9 and 6 cases of PVST in patients with and without cirrhosis, respectively, (37.5% vs. 85.7%; P=0.037) resolved during hospitalization. In patients who underwent LS, a PLT count increasing to >8 times baseline levels after surgery was the risk factor for PVST after LS, and the sensitivity to anticoagulation postoperatively was significantly higher in patients without cirrhosis than in those with cirrhosis.