Background: Post-splenectomy portal venous thrombosis (PS-PVT) carries multiple threats to patients’ lives. Different variables were identified as risk factors for PS-PVT in cirrhotic patients. The aim of this study was to prospectively assess the incidence, risk factors, clinical presentation and treatment outcomes of PS-PVT in cirrhotic patients. Patients and methods: Sixty cirrhotic patients of Child class A submitted to open splenectomy were observed, both clinically and by Duplex ultrasound (US) examination, for the development of PS-PVT. Results: Overall, 17 patients (28.3%) developed PS-PVT at a median interval of 4.5 days (21 hours-7 days) post-splenectomy. Univariate analysis showed that lower preoperative platelet count (P<0.0460) and white blood cell (WBC) count (P<0.0001) and wider splenic vein diameter (SVD) (P<0.0001) correlated with PS-PVT. Multivariate analysis identified lower preoperative WBC count [odds ratio (OR): 0.651, 95% confidence interval (CI): 0.245-0.893, P<0.005] and wider SVD (OR: 2.383, 95% CI: 1.558-3.646., P<0.001) as independent risk factors of PS-PVT. While 16 out of the 17 patients (94%) who had these 2 risk factors developed PS-PVT, only 1 out of the 43 patients (2.3%) who didn’t have the same risk factors developed thrombosis. All 17 patients had complete resolution of their thrombosis on anticoagulation therapy within 3-6 months without complications or mortality. Conclusion: PVT is a common complication of splenectomy in cirrhotic patients. Patients with low WBC count and wide SVD are highly susceptible to develop this complication mandating close observation from the 1st PO day and immediate anticoagulation after diagnosis.
| Published in | Journal of Surgery (Volume 5, Issue 6) |
| DOI | 10.11648/j.js.20170506.14 |
| Page(s) | 105-110 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2017. Published by Science Publishing Group |
Splenectomy, Portal Vein Thrombosis, Cirrhosis, Risk Factors
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APA Style
Hamdy Sedky Abd Allah, Mohamad Hamdy Abo-Ryia, Sherif Abd-Al Fattah Saber. (2017). Post-Splenectomy Portal Venous Thrombosis in Cirrhotic Patients: An Observational Clinical Trial. Journal of Surgery, 5(6), 105-110. https://doi.org/10.11648/j.js.20170506.14
ACS Style
Hamdy Sedky Abd Allah; Mohamad Hamdy Abo-Ryia; Sherif Abd-Al Fattah Saber. Post-Splenectomy Portal Venous Thrombosis in Cirrhotic Patients: An Observational Clinical Trial. J. Surg. 2017, 5(6), 105-110. doi: 10.11648/j.js.20170506.14
AMA Style
Hamdy Sedky Abd Allah, Mohamad Hamdy Abo-Ryia, Sherif Abd-Al Fattah Saber. Post-Splenectomy Portal Venous Thrombosis in Cirrhotic Patients: An Observational Clinical Trial. J Surg. 2017;5(6):105-110. doi: 10.11648/j.js.20170506.14
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Download@article{10.11648/j.js.20170506.14,
author = {Hamdy Sedky Abd Allah and Mohamad Hamdy Abo-Ryia and Sherif Abd-Al Fattah Saber},
title = {Post-Splenectomy Portal Venous Thrombosis in Cirrhotic Patients: An Observational Clinical Trial},
journal = {Journal of Surgery},
volume = {5},
number = {6},
pages = {105-110},
doi = {10.11648/j.js.20170506.14},
url = {https://doi.org/10.11648/j.js.20170506.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170506.14},
abstract = {Background: Post-splenectomy portal venous thrombosis (PS-PVT) carries multiple threats to patients’ lives. Different variables were identified as risk factors for PS-PVT in cirrhotic patients. The aim of this study was to prospectively assess the incidence, risk factors, clinical presentation and treatment outcomes of PS-PVT in cirrhotic patients. Patients and methods: Sixty cirrhotic patients of Child class A submitted to open splenectomy were observed, both clinically and by Duplex ultrasound (US) examination, for the development of PS-PVT. Results: Overall, 17 patients (28.3%) developed PS-PVT at a median interval of 4.5 days (21 hours-7 days) post-splenectomy. Univariate analysis showed that lower preoperative platelet count (P<0.0460) and white blood cell (WBC) count (P<0.0001) and wider splenic vein diameter (SVD) (P<0.0001) correlated with PS-PVT. Multivariate analysis identified lower preoperative WBC count [odds ratio (OR): 0.651, 95% confidence interval (CI): 0.245-0.893, P<0.005] and wider SVD (OR: 2.383, 95% CI: 1.558-3.646., P<0.001) as independent risk factors of PS-PVT. While 16 out of the 17 patients (94%) who had these 2 risk factors developed PS-PVT, only 1 out of the 43 patients (2.3%) who didn’t have the same risk factors developed thrombosis. All 17 patients had complete resolution of their thrombosis on anticoagulation therapy within 3-6 months without complications or mortality. Conclusion: PVT is a common complication of splenectomy in cirrhotic patients. Patients with low WBC count and wide SVD are highly susceptible to develop this complication mandating close observation from the 1st PO day and immediate anticoagulation after diagnosis.},
year = {2017}
}
TY - JOUR T1 - Post-Splenectomy Portal Venous Thrombosis in Cirrhotic Patients: An Observational Clinical Trial AU - Hamdy Sedky Abd Allah AU - Mohamad Hamdy Abo-Ryia AU - Sherif Abd-Al Fattah Saber Y1 - 2017/11/12 PY - 2017 N1 - https://doi.org/10.11648/j.js.20170506.14 DO - 10.11648/j.js.20170506.14 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 105 EP - 110 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20170506.14 AB - Background: Post-splenectomy portal venous thrombosis (PS-PVT) carries multiple threats to patients’ lives. Different variables were identified as risk factors for PS-PVT in cirrhotic patients. The aim of this study was to prospectively assess the incidence, risk factors, clinical presentation and treatment outcomes of PS-PVT in cirrhotic patients. Patients and methods: Sixty cirrhotic patients of Child class A submitted to open splenectomy were observed, both clinically and by Duplex ultrasound (US) examination, for the development of PS-PVT. Results: Overall, 17 patients (28.3%) developed PS-PVT at a median interval of 4.5 days (21 hours-7 days) post-splenectomy. Univariate analysis showed that lower preoperative platelet count (P<0.0460) and white blood cell (WBC) count (P<0.0001) and wider splenic vein diameter (SVD) (P<0.0001) correlated with PS-PVT. Multivariate analysis identified lower preoperative WBC count [odds ratio (OR): 0.651, 95% confidence interval (CI): 0.245-0.893, P<0.005] and wider SVD (OR: 2.383, 95% CI: 1.558-3.646., P<0.001) as independent risk factors of PS-PVT. While 16 out of the 17 patients (94%) who had these 2 risk factors developed PS-PVT, only 1 out of the 43 patients (2.3%) who didn’t have the same risk factors developed thrombosis. All 17 patients had complete resolution of their thrombosis on anticoagulation therapy within 3-6 months without complications or mortality. Conclusion: PVT is a common complication of splenectomy in cirrhotic patients. Patients with low WBC count and wide SVD are highly susceptible to develop this complication mandating close observation from the 1st PO day and immediate anticoagulation after diagnosis. VL - 5 IS - 6 ER -
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