Risk factors of portal venous thrombosis after laparoscopic splenectomy for hypersplenism in cirrho-tic portal hypertension

Abstract

Objective To investigate the risk factors of portal venous thrombosis (PVST) following laparoscopic splenectomy (LS) in cirrhotic patients with hypersplenism. Methods The clinical data of 62 patients with secondary hypersplenism due to cirrhotic portal hypertension admitted to the Clinical Medical College of Yangzhou University were retrospectively analyzed. These patients underwent LS from January 2013 to April 2014. Based on whether the patients had PVST on postoperative day (POD) 7 or not, the patients were categorized into the non-PVST and PVST groups. Fifteen perioperative variables were analyzed in these two groups. Results On univariate analysis, age and portal vein diameter in the PVST group were significantly higher and velocity of portal blood flow in the PVST group were significantly lower than those in the non-PVST group, (all P 50 years, portal vein diameter >13 mm and velocity of portal blood flow >18 cm/s were significantly correlated. Multivariate logistic regression showed that age >50 years and portal vein diameter >13 mm were significantly independent risk factors of PVST, and velocity of portal blood flow >18 cm/s was an independent protective factor. Conclusion Age >50 years and portal vein diameter >13 mm were independent risk factors, while velocity of portal blood flow >18 cm/s was an independent protective factor of postoperative PVST. Key words: Hypersplenism, cirrhosis, portal hypertension; Portal vein thrombosis; Splenectomy, laparoscopy