Korean J Hepatobiliary Pancreat Surg.  2008 Sep;12(3):156-161.

The Impact of Concomitant Splenectomy on the Portal Pressure in Patients with Liver Cirrhosis

• Nam KH
• Hwang YJ
• Cheon JM
• Kim SG
• Yeun YG

Abstract

PURPOSE: Concomitant splenectomy in cirrhotic patients is known to ameliorate the tendency to bleed and it decreases the portal venous pressure (PVP). However, the direct measurement of the change in the PVP after concomitant splenectomy has not yet been reported. We tried to measure the change of the PVP before and after splenectomy.
METHODS
From March 2000 to May 2006, 18 patients underwent anatomical liver resection with concomitant splenectomy. All the patients had liver cirrhosis, thrombocytopenia and/or esophageal varix. Through the 5 French feeding tube, which was inserted into the right gastroepiploic vein after laparotomy, we directly measured the PVP before and after splenectomy, and also under portal triad clamping (PTC).
RESULTS
After splenectomy, the PVP decreased significantly from 261.11+/-45.87 mmH2O to 221.11+/-38.48 mmH2O (p<0.05). Under PTC, the PVP decreased significantly from 605.00+/-116.48 mmH2O to 513.89+/-70.56 mmH2O (p<0.05).
CONCLUSION
Concomitant splenectomy in patients with liver cirrhosis resulted in a significant reduction of the PVP.

Keyword

Concomitant splenectomy; Portal venous pressure; Portal triad clamping

MeSH Terms

Constriction
Esophageal and Gastric Varices
Factor IX
Humans
Laparotomy
Liver
Liver Cirrhosis
Portal Pressure
Splenectomy
Thrombocytopenia
Veins
Factor IX