Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis

Kakinoki, Keitaro; Okano, Keiichi; Suto, Hironobu; Oshima, Masaharu; Hagiike, Masanobu; Usuki, Hisashi; Deguchi, Akihiro; Masaki, Tutomu; Suzuki, Yasuyuki

doi:10.1007/s00595-012-0413-4

Cited by 17 publications

(39 citation statements)

References 23 publications

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“…7,12,13 We also reported in a series of HALS for 28 patients with cirrhosis and thrombocytopenia that operation time, estimated blood loss, postoperative complications, and duration of hospital stay were similar to those reported previously, although simultaneous hepatectomy and esophagogastric devascularization were performed in 7 and 5 patients, respectively. 14 PVT is an important and potentially lifethreatening complication associated with splenectomy that has been reported to occur in 8-10% of patients. [15][16][17] In the current study, PVT occurred in 8 cases (18%), which was slightly greater than the previously reported rates.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic splenectomy for patients with liver cirrhosis: Improvement of liver function in patients with Child-Pugh class B

Yamamoto

Okano

Oshima

et al. 2015

Surgery

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Section: Discussionmentioning

confidence: 99%

“…14 In this study, we aimed to assess the short-term results of LS and its influence on hypersplenism and long-term liver function in the patients with chronic liver disease.…”

mentioning

confidence: 99%

Laparoscopic splenectomy for patients with liver cirrhosis: Improvement of liver function in patients with Child-Pugh class B

Yamamoto

Okano

Oshima

et al. 2015

Surgery

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“…After exclusion, 8 papers were included in our meta-analysis (Figure 1) [17–24]. Notably, a randomized controlled trial by Wang et al was terminated due to the absence of funding support [23].…”

Section: Resultsmentioning

confidence: 99%

Pharmacologic Prophylaxis of Portal Venous System Thrombosis after Splenectomy: A Meta-Analysis

Bai

Guo

et al. 2014

Gastroenterology Research and Practice

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Portal venous system thrombosis (PVST) is a life-threatening complication of splenectomy. A meta-analysis was conducted to explore the role of pharmacologic prophylaxis of PVST after splenectomy. Overall, 359 papers were initially identified via the PubMed, EMBASE, and Cochrane Library databases. Eight of them were eligible. The incidence of PVST after splenectomy was significantly lower in patients who received the preventive measures than in those who did not (odds ratio [OR]: 0.33, 95% confidence interval [CI]: 0.22–0.47, P < 0.00001). Subgroup analyses demonstrated that the significant difference remained in studies including patients with portal hypertension (n = 6), but not in those including patients with hematological diseases (n = 2); the significant difference remained in studies using any type of prophylactic drugs (anticoagulants [n = 6], thrombolytics [n = 1], and prostaglandin E1 [n = 1]); the significant difference remained in nonrandomized studies (n = 5), but not in randomized studies (n = 3). The risk of bleeding was similar between the two groups (OR: 0.65, 95% CI: 0.10–4.04, P = 0.64). In conclusion, pharmacologic prophylaxis might decrease the incidence of PVST after splenectomy in patients with portal hypertension and did not increase the risk of bleeding. However, the effect of pharmacologic prophylaxis of PVST in patients with hematological diseases remained questioned.

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“…One study found a significant correlation between thrombocytopenia and aetiology of cirrhosis. 20 In addition, another study showed that platelet distribution returned to normal after splenectomy, 21 which likely eliminated platelet retention by the splenic blood pool and removed the site of hypersplenism. However, peripheral cytopenia in hepatitis B-related cirrhotic portal hypertension are thought to be caused by several factors.…”

Section: Discussionmentioning

confidence: 99%

Distribution characteristics of cells in splenomegaly due to hepatitis B-related cirrhotic portal hypertension and their clinical importance

Han

et al. 2018

J Int Med Res

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ObjectivesTo investigate peripheral cytopenia in patients with splenomegaly due to hepatitis B-related cirrhotic portal hypertension (HBRCPH) by comparing blood cell counts from enlarged spleens with peripheral blood.MethodsThis prospective study involved patients undergoing splenectomy at the Nangfang Hospital from June 2013 to December 2015. Blood cell counts from peripheral blood were compared with those from splenic blood taken during splenectomies.ResultsClinical data were available from 30 patients. White blood cell (WBC), red blood cell (RBC) and platelet counts were statistically significantly lower in peripheral blood compared with splenic blood. After splenectomy, peripheral blood cell counts increased significantly compared with pre-operative levels. Platelet and WBC counts in the lower spleen were significantly higher than those in the porta lienis (middle segment) and upper spleen.ConclusionsIn patients with splenomegaly due to HBRCPH, the counts of three blood cell lineages were significantly higher in the spleen than in peripheral blood. Splenectomy can aid the return of peripheral blood cell counts to normal levels. The most significant retention of platelets and WBCs occurred in the lower spleen which may be useful information for surgeons performing partial splenectomies.

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Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis

Cited by 17 publications

References 23 publications

Laparoscopic splenectomy for patients with liver cirrhosis: Improvement of liver function in patients with Child-Pugh class B

Laparoscopic splenectomy for patients with liver cirrhosis: Improvement of liver function in patients with Child-Pugh class B

Pharmacologic Prophylaxis of Portal Venous System Thrombosis after Splenectomy: A Meta-Analysis

Distribution characteristics of cells in splenomegaly due to hepatitis B-related cirrhotic portal hypertension and their clinical importance

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