Effect of splenectomy on blood coagulation and fibrinolysis in liver cirrhosis

Abstract

The analysis of the blood coagulation and fibrinolysis system was performed to evaluate the effect of splenectomy for the patient of hepatic cirrhosis and the degree of recovery of hepatic function after surgical procedures.Seventeen patients with known hepatic cirrhosis were selected for study. All patients were performed splenectomy, devascularization, and esophageal transection, and were investigated about blood examination, biochemical test, blood coagulation and fibrinolysis test.1) Preoperative platelet count was 9.8×104±1.0 (SE). After splenectomy it was increased to 22.5×104±2.1 significantly. As platelet function, it showed high activity preoperatively but after operation normalized. On the other hand, there was a high statistical correlation between platelet count and weight of removed spleen. (r=-0.57, p<0.001).2) The preoperative fibrinogen (Fbg.) level was lower than normal and this thend was not changed after operation. In the prothrombin time (PT) and the hepaplastin test (HPT), the vitamin K dependent factors were decreased in cirrhotic patients and it's values were not recovered by the operation. The Fbg. and PT level of preoperative cirrhotic patients were well correlated with their serum albumin level.3) In cases of which the fibrinogen and fibrin degradation product (FDP) value showed more than 10μg/ml, the disappearance of FDP was not observed until about 4 weeks after the operation. There is a high statistical correlation between the Fbg. and FDP in cirrhotic patients (r=-0.67, p<0.001).4) The patients having continous fever after splenectomy showed low platelet count and low level of Fbg. postoperatively.