Preventive use of low molecular weight heparin in portal vein system thrombosis after splenectomy without portal hypertension
Qiang Wei,
Shengmin Mei,
Zhifei Fu,
Xiaodong Wang,
Chengzuo Han,
Jun Chen,
Peng Liu,
Bin Chen,
Xin Fang,
Changku Jia,
Shusen Zheng,
Xiao Xu
Affiliations
Qiang Wei
The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310006, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China; Zhejiang University School of Medicine, Hangzhou, 310058, China
Shengmin Mei
Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Zhifei Fu
The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310006, China
Xiaodong Wang
The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310006, China
Chengzuo Han
Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China; Zhejiang University School of Medicine, Hangzhou, 310058, China
Jun Chen
The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310006, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China; Zhejiang University School of Medicine, Hangzhou, 310058, China
Peng Liu
Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
Bin Chen
Information Center, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
Xin Fang
Department of Vascular Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
Changku Jia
Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
Shusen Zheng
Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Xiao Xu
The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310006, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China; Zhejiang University School of Medicine, Hangzhou, 310058, China; Corresponding author.
Background/aim: Portal vein system thrombosis (PVST) is a serious complication after splenectomy, and many researches focus on how to prevent PVST these years. The current study aimed to explore an effectively method to prevent PVST occur after splenectomy. Methods: Records of patients performed with splenectomy from January 2018 to December 2020 were reviewed. Clinical parameters, including patient history, physical examination, and the results of laboratory investigations, were analyzed. Results: One hundred and eighty patients (127 females) were included. Twenty-four patients were confirmed PVST by Color Doppler ultrasonography and CTA (thrombus group) and the others were not (non-thrombus group). One hundred and twenty patients were performed with laparoscopic splenectomy (LS) and 53 were open splenectomy (OS). Seventeen PVST were found in LS patients and 7 PVST were found in OS patients (P = 0.974). The average time of thrombosis was 4.48 ± 2.9 days after operation. The proportion of postoperative preventive use of low molecular weight heparin (LMWH) in non-thrombus group was higher than that in thrombus group (27.6% vs. 8.3%, P = 0.045). Compared with the non-thrombus group, the thrombus group showed significantly higher serum alanine transaminase (ALT) and aspartate transaminase (AST) 7 days after splenectomy (79.67 ± 39.1 U/L vs. 29.34 ± 2.5 U/L, P = 0.001; 192.4 ± 145.8 U/L vs. 30.54 ± 3.0 U/L, P < 0.001). Conclusion: Laparoscopic splenectomy does not seem to increase the occurrence of PVST in patients without portal hypertension. Early postoperative preventive use of LMWH after splenectomy may prevent the formation of PVST.
