Laparoscopic splenectomy reverses thrombocytopenia in patients with hepatitis C cirrhosis and portal hypertension

Laparoscopic splenectomy with peginterferon and ribavirin therapy for patients with hepatitis C virus cirrhosis and hypersplenism

“…The effect, which is dose dependent, usually occurs within the first few weeks after IFN therapy and necessitates dose reductions or withdrawal from therapy for up to 25% of patients [5,[7][8][9]. The decreased platelet count can be reversed by splenectomy in patients with HCV cirrhosis, usually in combination with portal hypertension [11][12][13]. A recent report indicated that Lap-Sp not only induces a significant increase in the number of platelets but also has the advantages of small incisions, decreased hospitalization, early return to work, and diminished postoperative pain.…”

“…The results of two recent studies indicate that Lap-Sp is not necessarily contraindicated for cirrhotic patients with hypersplenism [11,12]. To date, the indications for splenectomy in patients with chronic HCV have been for endoscopic treatment-resistant esophagogastric varices or HCC requiring other invasive therapies such as hepatectomy [10].…”

“…To date, the indications for splenectomy in patients with chronic HCV have been for endoscopic treatment-resistant esophagogastric varices or HCC requiring other invasive therapies such as hepatectomy [10]. Although Kercher et al [12] reported that Lap-Sp allowed for the administration of IFN therapy in 12 cases of HCV cirrhosis, their study was limited by the small number of subjects and the relatively short follow-up period. Therefore, Fig.…”

“…Since splenectomy using laparoscopic devices was first reported in 1992, the indications for applying this technique have expanded [10][11][12]. Laparoscopic splenectomy (Lap-Sp) as treatment against hypersplenism with splenomegaly alone is not contraindicated for cirrhotic patients [11,12], but to date, evidence is lacking that Lap-Sp is effective for subsequent IFN therapy.…”

“…Laparoscopic splenectomy (Lap-Sp) as treatment against hypersplenism with splenomegaly alone is not contraindicated for cirrhotic patients [11,12], but to date, evidence is lacking that Lap-Sp is effective for subsequent IFN therapy. Therefore, we evaluated whether Lap-Sp contributes to the completion and curability of treatment with peg-IFN ?…”