Usefulness of splenectomy in patients with chronic liver disease

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It is reported that splenectomy improves thrombocytopenia and liver function in patients with chronic liver disease. However, exact significance of splenectomy still remains unsettled. Seventeen patients with chronic hepatitis C who were to receive IFN therapy, and eleven patients with decompensated liver cirrhosis, underwent splenectomy. Platelet count, white blood cell count, and that of neutrophils were significantly increased after splenectomy, and IFN therapy could be started in all patients. The results of IFN therapy demonstrated sustained viral response (SVR) in four patients, biochemical response (BR) in one, relapse in four and no response in five. Viral serotype of all the SVR cases were type 2. No patient withdrew from IFN therapy due to Thrombocytopenia.Child-Pugh score was significantly improved after splenectomy. Levels of albumin, total bilirubin, prothrombin time, cholinesterase were similarly improved. Moreover, the number of CD34 positive hematopoietic stem cells in peripheral blood significantly increased after splenectomy.In conclusion, splenectomy not only improves thrombocytopenia of patients with chronic liver disease, but promote the liver regeneration. It is suggested that splenectomy improves a long-term prognosis in patients with chronic liver disease.