Postsplenectomy portal vein thrombosis in liver fibrosis

ABSTRACT

Splenectomy and esophagogastric devascularization is one of the surgical procedures for bleeding esophageal varices. The aim of the prospective investigation was to find out whether there is any correlation between postsplenectomy portal vein thrombosis and the preoperative and postoperative platelet count and aggregation and the clotting parameters. In the present study, 50 consecutive patients with schistosomal hepatic fibrosis and esophageal varices and 15 control patients undergoing upper abdominal surgery, were investigated. Preoperatively, the platelet count and aggregation and the fibrin degradation products were highly different [P <0.001] while the prothrombin and partial thromboplastin times were significantly different [P <0.05] from the control. In the schistosomal patients, portal vein thrombosis was found in 14% [n = 7] by ultrasonography and was significantly correlated to the patients age [P <0.05], preoperative portal vein diameter [P <0.05], postoperative thrombocytosis from the first postoperative week onwards [P <0.001] and the improved platelets aggregatability at the first and second postoperative weeks. It was concluded that the patients with the above criteria could be considered for prophylactic antiplatelets therapy following splenectomy