Concomitant Splenectomy during Hepatectomy in Patients with Liver Cirrhosis and Thrombocytopenia / 한국간담췌외과학회지

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.