간경화 환자의 간절제시 동반 비장절제술에 의한 간문맥압의 변화

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

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.