Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.241
Peer-review started: October 22, 2023
First decision: December 8, 2023
Revised: December 21, 2023
Accepted: January 8, 2024
Article in press: January 8, 2024
Published online: February 27, 2024
Processing time: 127 Days and 18.2 Hours
Portal vein thrombosis (PVT) is a commonthsn complication after splenectomy in patients with cirrhosis. However, the predictors of postoperative PVT are not known.
To investigate the predictors of PVT after splenectomy in patient with cirrhosis.
A total of 45 patients with cirrhosis who underwent splenectomy were consecutively enrolled from January 2017 to December 2018. The incidence of PVT at 1 months, 3 months, and 12 months after splenectomy in patients with cirrhosis was observed. The hematological indicators, biochemical and coagulation parameters, and imaging features were recorded at baseline and at each observation point. The univariable, multivariable, receiver operating characteristic curve and time-dependent curve analyses were performed.
The cumulative incidence of PVT was 40.0%, 46.6%, and 48.9% at 1 months, 3 months, and 12 months after splenectomy. Multivariable analysis showed that portal vein diameter (PVD) ≥ 14.5 mm and monthsdel end-stage liver disease (MELD) score > 10 were independent predictors of PVT at 1 months, 3 months, and 12 months after splenectomy (P < 0.05). Time-dependent curve showed that the cumulative incidence of PVT was significantly different between patients with MELD score ≤ 10 and > 10 (P < 0.05). In addition, the cumulative incidence of PVT in the PVD ≥ 14.5 mm group was significantly higher than that in the PVD < 14.5 mm group (P < 0.05).
Wider PVD and MELD score > 10 were independent predictors of PVT at 1 months, 3 months, and 12 months after splenectomy in patient with cirrhosis.
Core Tip: Portal vein diameter (PVD) ≥ 14.5 mm was independent predictors of portal vein thrombosis (PVT) at 1-months, 3-months, and 12-months after splenectomy. End-stage liver disease score > 10 was independent predictors of PVT at 1-months, 3-months, and 12-months after splenectomy. The patients with PVD ≥ 14.5 mm and/or end-stage liver disease score > 10 in preoperative, preoperative treatment of reducing portal vein pressure and improving liver function may help to reduce the incidence of PVT after splenectomy.