The Impact of Concomitant Splenectomy on the Portal Pressure in Patients with Liver Cirrhosis

간경화 환자의 간절제시 동반 비장절제술에 의한 간문맥압의 변화

  • Nam, Kyung-Hee (Department of Surgery, Kyungpook National University, College of Medicine) ;
  • Hwang, Yoon-Jin (Department of Surgery, Kyungpook National University, College of Medicine) ;
  • Cheon, Jae-Min (Department of Surgery, Kyungpook National University, College of Medicine) ;
  • Kim, Sang-Geol (Department of Surgery, Kyungpook National University, College of Medicine) ;
  • Yeun, Young-Guk (Department of Surgery, Kyungpook National University, College of Medicine)
  • 남경희 (경북대학교 의과대학 외과학교실) ;
  • 황윤진 (경북대학교 의과대학 외과학교실) ;
  • 천재민 (경북대학교 의과대학 외과학교실) ;
  • 김상걸 (경북대학교 의과대학 외과학교실) ;
  • 윤영국 (경북대학교 의과대학 외과학교실)
  • Published : 2008.09.30

Abstract

Purpose: Concomitant splenectomy in cirrhotic patients is known to ameliorate the tendency to bleed and it decreases the portal venous pressure (PVP). However, the direct measurement of the change in the PVP after concomitant splenectomy has not yet been reported. We tried to measure the change of the PVP before and after splenectomy. Methods: From March 2000 to May 2006, 18 patients underwent anatomical liver resection with concomitant splenectomy. All the patients had liver cirrhosis, thrombocytopenia and/or esophageal varix. Through the 5 French feeding tube, which was inserted into the right gastroepiploic vein after laparotomy, we directly measured the PVP before and after splenectomy, and also under portal triad clamping (PTC). Results: After splenectomy, the PVP decreased significantly from $261.11{\pm}45.87$ mm$H_{2}O$ to $221.11{\pm}38.48$ mm$H_{2}O$ (p<0.05). Under PTC, the PVP decreased significantly from $605.00{\pm}116.48$ mm$H_{2}O$ to $513.89{\pm}70.56$ mm$H_{2}O$ (p<0.05). Conclusion: Concomitant splenectomy in patients with liver cirrhosis resulted in a significant reduction of the PVP.

Keywords