Efficacy of splenectomy on liver function and long-term outcome of patients with portal hypertension

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  • Miyoshi Takayuki
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences
  • Takatsuki Mitsuhisa
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences
  • Hidaka Masaaki
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences
  • Soyama Akihiko
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences
  • Hamada Takashi
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences
  • Eguchi Susumu
    Department of Surgery, Nagasaki Graduate School of Biomedical Sciences

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  • 当科における門脈圧亢進症に対する脾臓摘出術の効果の検討
  • トウ カ ニ オケル モンミャクアツ コウシンショウ ニ タイスル ヒゾウ テキシュツジュツ ノ コウカ ノ ケントウ

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Abstract

<p>Although surgical procedures including Hassab's decongestion operation and splenectomy have been done for patients with esophageal or gastric varices and/or splenomegaly, the efficacy of these procedures on long-term prognoses of patients with hypertension remain to be elucidated. Thus, clinical features and outcome of 17 patients receiving splenectomy for hypertension between 2005 and 2017, consisting of 14 patients with cirrhosis and 3 patients with idiopathic portal hypertension (IPH), were retrospectively evaluated, and were compared to those of 46 patients with cirrhosis manifesting class A Child-Pugh scores seen between 2008 and 2014. Peripheral counts of leukocytes and platelets increased following splenectomy both in patients with cirrhosis and IPH, but liver function tests such as serum albumin levels decreased following the procedure in patients with cirrhosis, while such derangement did not occur in patients with IPH. In patients manifesting class A Child-Pugh scores, the mean survival days did not differ between 8 patients receiving splenectomy and 46 patients treated without splenectomy. Splenectomy was effective in improvement of liver function for patients with IPH, whereas was not effective for those with cirrhosis manifesting class A Child-Pugh score, and the procedure did not improve the long-term outcome of patients.</p>

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