Effect of low molecular weight heparin and dextran on the early prevention of portal vein system thrombosis after splenectomy for portal hypertesion

Abstract

Objective To evaluate the preventive effect of low molecular weight heparin (LMWH) and dextran on early portal vein system thrombosis (PVST) after splenectomy for patients with hypersplenism caused by portal hypertesion. Methods Clinical data of 79 splenectomy cases of portal hypertension from June 2010 to September 2015 were retrospectively analyzed. These cases were categorized into early phase group (n=37) and middle phase group (n=42) according to the start time of LMWH treatment. Results There were no bleeding and death cases during anticoagulation therapy. The total incidence of PVST was 38%. Eleven of 37 patients (30%) in the early phase group, including 2 in portal vein main trunk. Nineteen of 42 patients (45%) in the middle phase group had PVST, including 9 in the main trunk. The incidences of PVST between the two groups were not significantly different (χ2=2.009, P>0.05), but the incidence of main trunk thrombosis was significantly lower in the early phase group than that in the middle group (χ2=4.214, P<0.05). Conclusions Early anticoagulation with low molecular weight heparin and dextran reduces portal vein trunk thrombosis after splenectomy for portal hypertension. Key words: Venous thrombosis; Heparin, low-molecular-weight; Splenectomy