Cause analysis of early portal vein thrombosis after esophagogastric devascularization and splenectomy in cirrhotic patients with portal hypertension

• Main Author: WU Xiaofeng
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2015-03-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: liver cirrhosis; hypertension; portal; splenectomy; venous thromboembolism; risk factors
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=6374&ClassID=212131156

ObjectiveTo identify the causative factors for early portal vein thrombosis (EPVT) after esophagogastric devascularization and splenectomy (EGDS) in cirrhotic patients with portal hypertension. MethodsA 3-month follow-up of a retrospective study was performed on 83 patients who received EGDS at our hospital from January 2012 to December 2013. The patients were assigned to thrombosis and control groups given the presence or absence of EPVT. Continuous and categorical data were compared between groups using t test and χ2 test, respectively. Logistic regression models were adopted for multivariate analysis. ResultsEPVT occurred in 44 patients after EGDS, accounting for an incidence of 53.01%. There were significant differences between the thrombosis and control groups in terms of preoperative portal vein diameter (P=0.014), postoperative portal vein diameter (P=0.017), spleen volume (P=0.013), and portal venous flow alteration (P=0.030); these four parameters were risk factors for EPVT after EGDS. Logistic regression analysis showed that portal venous flow alteration after surgery was an independent risk factor for EPVT (P=0.003); portal venous flow and pressure alterations after surgery, operation time, intraoperative bleeding, and maximum platelet count were unrelated to EPVT. ConclusionHemodynamic factors impact EPVT after EGDS, for which individualized anticoagulant therapy is necessary.