AIM To determine the outcomes of partial splenic em-bolization(PSE) for massive splenomegaly due to idiopathic portal hypertension(IPH).METHODS In this prospective study, we evaluated the charac-teristics and prognosi...AIM To determine the outcomes of partial splenic em-bolization(PSE) for massive splenomegaly due to idiopathic portal hypertension(IPH).METHODS In this prospective study, we evaluated the charac-teristics and prognosis of consecutive patients with IPH who underwent PSE for all indications at a single medical center between June 2009 and January 2015. The inclusion criteria were: presence of hypersplenism, massive splenomegaly, and resultant pancytopenia. The exclusion criteria were: presence of other diseases causing portal hypertension. During the post-PSE period, the patients were hospitalized. All patients underwent abdominal computed tomography imaging 4 wk post-PSE to determine total splenic and non-infarcted splenic volumes.RESULTS A total of 11 patients, with median age of 33.27 ± 4.8 years, were included in the study. Mean spleen size was 22.9 cm(21-28 cm), and severe hypersplenismwas diagnosed in all patients before PSE. Post-PSE, leukocyte and platelet counts increased significantly, reaching peak levels in the second week with gradual decreases thereafter. Liver function tests did not exhibit significant changes during post-intervention follow-up. All patients developed post-embolization syndrome, and one patient experienced serious complications; all complications were successfully treated with conservative therapy and no death occurred. CONCLUSION Our findings showed that PSE has a lower complication rate than previously-reported surgical complication rates, which supports this intervention as a viable alternative for high-risk operable patients with severe hypersplenism.展开更多
Although the clinical benefit of laparoscopic splenectomy and devascularization（LSD） has been elaborated in many studies,its application in massive splenomegaly remains controversial.We conducted a retrospective res...Although the clinical benefit of laparoscopic splenectomy and devascularization（LSD） has been elaborated in many studies,its application in massive splenomegaly remains controversial.We conducted a retrospective research to assess the curative efficacy of LSD for massive splenomegaly due to portal hypertension.Forty-seven patients with massive splenomegaly due to portal hypertension were enrolled in this study,and divided into two groups.Twenty-one patients underwent open splenectomy and devascularization（OSD） from June 2010 to October 2012（OSD group）.From March 2013 to February 2015,LSD was performed on 26 patients（LSD group）.Perioperative variables were analyzed.Compared to OSD,LSD was associated with less blood loss（241.9±110.0 m L vs.319.0±139.5 m L,P〈0.05）,more rapid resumption of oral diet（2.46±0.95 days vs.3.76±1.09 days,P〈0.05）,and shorter postoperative hospital stay（5.35±1.65 days vs.7.24±1.55 days,P〈0.05）.It was concluded that for patients with massive splenomegaly due to portal hypertension,LSD is feasible and as safe as OSD.展开更多
文摘AIM To determine the outcomes of partial splenic em-bolization(PSE) for massive splenomegaly due to idiopathic portal hypertension(IPH).METHODS In this prospective study, we evaluated the charac-teristics and prognosis of consecutive patients with IPH who underwent PSE for all indications at a single medical center between June 2009 and January 2015. The inclusion criteria were: presence of hypersplenism, massive splenomegaly, and resultant pancytopenia. The exclusion criteria were: presence of other diseases causing portal hypertension. During the post-PSE period, the patients were hospitalized. All patients underwent abdominal computed tomography imaging 4 wk post-PSE to determine total splenic and non-infarcted splenic volumes.RESULTS A total of 11 patients, with median age of 33.27 ± 4.8 years, were included in the study. Mean spleen size was 22.9 cm(21-28 cm), and severe hypersplenismwas diagnosed in all patients before PSE. Post-PSE, leukocyte and platelet counts increased significantly, reaching peak levels in the second week with gradual decreases thereafter. Liver function tests did not exhibit significant changes during post-intervention follow-up. All patients developed post-embolization syndrome, and one patient experienced serious complications; all complications were successfully treated with conservative therapy and no death occurred. CONCLUSION Our findings showed that PSE has a lower complication rate than previously-reported surgical complication rates, which supports this intervention as a viable alternative for high-risk operable patients with severe hypersplenism.
文摘Although the clinical benefit of laparoscopic splenectomy and devascularization（LSD） has been elaborated in many studies,its application in massive splenomegaly remains controversial.We conducted a retrospective research to assess the curative efficacy of LSD for massive splenomegaly due to portal hypertension.Forty-seven patients with massive splenomegaly due to portal hypertension were enrolled in this study,and divided into two groups.Twenty-one patients underwent open splenectomy and devascularization（OSD） from June 2010 to October 2012（OSD group）.From March 2013 to February 2015,LSD was performed on 26 patients（LSD group）.Perioperative variables were analyzed.Compared to OSD,LSD was associated with less blood loss（241.9±110.0 m L vs.319.0±139.5 m L,P〈0.05）,more rapid resumption of oral diet（2.46±0.95 days vs.3.76±1.09 days,P〈0.05）,and shorter postoperative hospital stay（5.35±1.65 days vs.7.24±1.55 days,P〈0.05）.It was concluded that for patients with massive splenomegaly due to portal hypertension,LSD is feasible and as safe as OSD.
