Journal of Practical Hepatology ›› 2020, Vol. 23 ›› Issue (3): 409-412.doi: 10.3969/j.issn.1672-5069.2020.03.027

• Liver cirrhosis • Previous Articles    

Prevention of portal vein thrombosis in patients with cirrhotic portal hypertension aftersplenectomy and devascularization

Han Dong, Peng Jingwei, Xie Huijin.   

  1. Department of General Surgery, Laiwu People's Hospital, Jinan 271100, Shandong Province,China
  • Published:2020-05-27

Abstract: Objective The aim of this study was to investigate the prevention of portal vein thrombosis (PVT) in patients with cirrhotic portal hypertension after spleen resection and devascularization. Methods 60 patients with cirrhotic portal hypertension were recruited in our hospital between January 2017 and March 2019, and all underwent splenectomy and periorbital devascularization. After operation, the patients were randomly divided into group A (n=30) and group B (n=30), and the patients in group B were given very short-term anti-coagulant therapy when any parameters suggesting necessary. Results 20 patients (66.7%) out of 30 in group B received anti-coagulant therapy after operation, and at the end of three weeks, the sonography demonstrated PVT in 15 patient (25.0%), 11(36.7%) in group A and 4【(13.3%),P<0.05】 in group B; the portal diameter in patients with PVT was (1.5±0.3)cm, not significantly different compared to 【(1.4±0.2)cm, P>0.05】 in those without PVT, while the blood velocity in patients with PVT was (12.3±1.4)cm/s, much slower than 【(14.5±1.7)cm/s, P<0.05】 in patients without; serum D-dimer level in patients with PVT was much higher than that in patients without PVT (P<0.05); the platelet count in patients with PVT was (142.6±58.9)×109/L, significantly higher than thatin those without . Conclusion The application of splenectomy and devascularization in the treatment of patients with cirrhotic portal hypertension might lead to the PVT under some circumstances, and anti-coagulant therapy should be given in time to prevent it happening.

Key words: Cirrhosis, Portal hypertension, Splenectomy and devascularization, Portal vein thrombosis, D-dimer, Anti-coagulants