Risk factors of portal vein thrombosis after splenectomy in cirrhotic patients: a Meta-analysis

Abstract

Objective To study the perioperative predictors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients.Methods We searched the Web of Science,PubMed,EMBASE,Science Direct,CNKI,VIP,CSCD,and Wan Fang Databases up to April 2014.Only case-controlled studies which evaluated predictive factors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients were included.The Stata 12 software was used to perform the meta-analysis.Results Twenty-four casecontrolled studies were included.The sample size was 4 335,and the incidence rate of PVT was 25.0％.The risk factors of PVT included splenic volume (WMD =13.75,95％ CI:6.47 ～21.00),splenic vein diameter (WMD =1.34,95％ CI:0.39 ～ 2.30),portal vein diameter (WMD =1.54,95 ％ CI:0.56 ～ 2.52 ;WMD=2.09,95％CI:0.55 ～3.64),portal venous flow (WMD =-5.78,95％ CI:-10.46 ～-1.10;WMD =-5.57,95 ％ CI:-5.92 ～-5.22),difference in portal venous pressure (WMD =1.90,95 ％ CI:1.29～2.50) and ascites (OR =1.83,95％ CI:1.19,2.82).There were no significant differences between patients with and without PVT in terms of sex,age,Child-Pugh classification,prothrombin time,PLT,D-dimer,operating time.Conclusion The risk factors of portal vein thrombosis after splenectomy in cirrhotic patients were splenic volume,splenic vein diameter,portal vein diameter,portal venous flow,difference in portal venous pressure and ascites. Key words: Liver cirrhosis; Splenectomy; Portal vein thrombosis