Impact of splenectomy with periesophagogastric devascularization on liver function of patients with liver cirrhosis and hypersplenism

Abstract

Objective To investigate the impact of splenectomy with periesophagogastric devascularization on liver function of patients with liver cirrhosis and hypersplenism. Methods Clinical data of 177 patients with liver cirrhosis and hypersplenism who underwent splenectomy with periesophagogastric devascularization in the Third Affiliated Hospital of Sun Yat-sen University from January 2010 to December 2012 were retrospectively analyzed. There were 120 males and 57 females with the mean age of (54±13) years old. The informed consents of all patients were obtained and the ethical committee approval was received. Firstly splenectomy was performed during the operation, and then the dilated esophageal and gastric fundus veins were dissected and cut off. The changes of blood routine and liver function of the patients before and 5 d, 10 d, 3 months after operations were observed. The measurement data between multiple groups were compared by one-way analysis of variance and LSD-t test. Results The hypersplenism of patients improved markedly. The white blood cell (WBC) and platelets (Plt) levels 5 d, 10 d, 3 months after operations significantly increased when compared with those before operations (LSD-t =14.37, 10.67, 6.60 and 5.06, 11.43, 12.10; P<0.05). And the liver function of patients also improved markedly. The aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TB) levels 10 d, 3 months after operations significantly decreased when compared with those before operations (LSD-t =7.80, 10.09, 8.21 and 10.76, 12.51, 11.13; P<0.05). Conclusion Splenectomy with periesophagogastric devascularization can not only cure the hypersplenism of patients with liver cirrhosis and hypersplenism, but also markedly improve the liver function of them. Key words: Splenectomy; Periesophagogastric devascularization; Liver cirrhosis; Hypersplenism; Liver function tests