Abstract: Objective The purpose of this study was to compare the incidence of portal vein thrombosis (PVT) after splenectomy or transjugular portal systemic shunt(TIPS)in patients with cirrhosis and hypersplenism. Methods 96 patients with cirrhosis and hypersplenism were enrolled and underwent splenectomy (n=45) or TIPS (n=51) in the Second Hospital, Lanzhou University, between January 2017 and December 2018, and all the patients were followed-up for one years. The PVT was diagnosed on ultrasonography, CT or CTA. The cumulative incidences between the two groups were compared by Kaplan-Meier method. Results At 1 month, 3 months, 6 months and 12 months after operation, the cumulative incidences of PVT in patients receiving splenectomy were 40.0%, 46.7%, 48.9% and 48.9%, significantly higher than 7.8%, 9.8%, 15.7% and 21.6% (P<0.05) in patients underwent TIPS; in patients receiving splenectomy, the baseline material analysis showed that the diameter of portal vain in 22 patients with PVT was significantly wider than in 23 patients without(P<0.05); one-year after TIPS, the incidence of PVT was 21.6%, and there were no significant differences as respect to baseline materials between patients with and those without PVT(P>0.05). Conclusion The cumulative incidence of PVT in patients with cirrhosis after splenectomy is relatively higher than that after TIPS. Therefore, the clinicians should carefully evaluate patient's condition before operation, strictly meeting the indications of splenectomy or TIPS, and make the appropriate choice in this setting.

Key words: Liver cirrhosis, Hypersplenism, Splenectomy, Transjugular portal systemic shunt, Portal vein thrombosis