Korean J Hepatobiliary Pancreat Surg.  2002 Dec;6(2):117-122.

Concomitant Splenectomy during Hepatectomy in Patients with Liver Cirrhosis and Thrombocytopenia

• Shin MH
• Lim YS
• Hwang YJ
• Kim YI

Abstract

BACKGROUND/AIMS: Resection of hepatocellular carcinoma in patients with liver cirrhosis and thrombocytopenia is risky. The benefit of concomitant splenectomy in cirrhotic patients is controversial.
METHODS
To evaluate the efficacy of concomitant splenectomy in patients with liver cirrhosis and thrombocytopenia, 13 cirrhotic patients with thrombocytopenia (platelet count< or =80,000/mm3) were divided by two groups (Group I: the patients without concomitant splenectomy during hepatectomy, Group II: the patients with concomitant splenectomy). Intraoperative and postoperative parameters were retrospectively reviewed.
RESULTS
Group II patients needed less amount of postoperative blood transfusion (Group I: 178.3+/-150 ml PRC in 3 patients, Group II: 107.1+/-100 ml in 2 patients, p=0.012, p= 0.041) and the platelet count was elevated to above 250,000/mm3 (p=0.003) and showed lower serum bilirubin level (p=0.037) within 1 week of operation in group II patients.
CONCLUSION
The concomitant splenectomy during in patients of liver cirrhosis with thrombocytopenia may improve liver function and elevate platelet count.

Keyword

Concomitant splenectomy; Liver cirrhosis; Thrombocytopenia

MeSH Terms

Bilirubin
Blood Transfusion
Carcinoma, Hepatocellular
Hepatectomy*
Humans
Liver Cirrhosis*
Liver*
Platelet Count
Retrospective Studies
Splenectomy*
Thrombocytopenia*
Bilirubin