Prognostic capability of portal vein thrombosis for rebleeding in cirrhotic patients after esophagogastric devascularization and splenectomy

Abstract

Background Esophagogastric devascularization and splenectomy (EGDS) is widely used to treat patients with portal hypertension in China. This study aimed to determine the risk factors of rebleeding after EGDS and evaluate the effect of portal vein thrombosis (PVT) on rebleeding during the postoperative period after EGDS. Methods Cirrhotic patients with portal hypertension who had undergone EGDS were included. The patients were assigned to either the rebleeding or the non-rebleeding group with follow-up time. Results A total of 138 consecutive patients who underwent EGDS and met the criteria were included in this study. The 3-year and 5-year rebleeding rates of all patients were 18.12% (25/138) and 27.54% (38/138), respectively. The total bilirubin (TBIL) (HR: 2.392, 95% CI 1.032–5.545, p = 0.042) and PVT (HR: 3.345, 95% CI 1.477–7.573, p = 0.004) were identified as the predictors of 3-year rebleeding in univariate analysis. Multivariate analysis revealed that the PVT (HR: 3.967, 95% CI 1.742–9.035, p = 0.001) was an independent factor. Hemoglobin > 87.5 g/L (HR: 3.104, 95% CI 1.283–7.510, p = 0.012) and PVT (HR: 2.349, 95% CI 1.231–4.483, p = 0.010) were the predictors of 5-year rebleeding in multivariate analysis. Albumin > 37.5 g/L was the only independent predictor of 3-year and 5-year rebleeding in patients with PVT. Conclusions The PVT is associated with 3-year and 5-year rebleeding in patients after EGDS but not 10-year rebleeding. Hemoglobin > 87.5 g/L is another predictor of 5-year rebleeding. High albumin levels may serve as a predictor of 3-year and 5-year rebleeding risk in patients with PVT.