Prophylactic anticoagulant therapy on portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization / 中华普通外科杂志

ABSTRACT

Objective:To investigate the preventive effect and safety of prophylactic anticoagulant therapy with different doses on portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization.Methods:109 hospitalized patients with portal hypertension undergoing laparoscopic procedures were divided into non preventive anticoagulant group(36 case), low dose prophylactic anticoagulant group(39 case), high dose preventive anticoagulant group(34 case). the incidence of portal vein thrombosis, the Yerdel greading, platelet count, APTT and bleeding complications were observed.Results:The incidence of portal vein thrombosis was 75%(27 cases), 49%(19 cases) and 29%(10 cases)respectively, (χ 2=14.719, P=0.001). There was no statistically significant difference among groups of postoperative platelet count[(569±46)×10 9/L, (565±42) ×10 9/L, (536±45)×10 9/L, F=0.074, P=0.909]; The level of D-dimer in the non-prophylactic anticoagulation group was significantly higher than that in the prophylactic anticoagulation groups[(6.35±1.24) mg/L, (2.97±0.48) mg/L, (2.13±0.38) mg/L, F=7.85, P=0.002]; The postoperative PT prolongation time in the prophylactic anticoagulation groups was longer than that in the non-prophylactic anticoagulation group[(18.5±0.7)s, (17.4±0.6)s, (12.7±0.2)s, F=30.88, P<0.001]. Conclusion:High dose prophylactic anticoagulation therapy can effectively reduce the incidence of portal vein thrombosis after laparoscopic splenectomy combined with pericardia devascularization without increasing the risk of postoperative bleeding.