Treatment for portal hypertension in liver cirrhosis with massive splenomegary:Effects of splenectomy
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概要
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We have preferably performed splenectomy for patients with liver cirrhosis (LC) and huge splenomegaly mainly aiming at an increase in platelet counts that enables interferon (IFN) treatment or treatment of hepato cellular carcinoma. In the course of the splenectomy we were aware that that splenectomy has additional clinical benefit.<BR>In the present study we have assessed the effect of splenectomy on portal hypertension, hepatic encephalopathy and several liver functions in 60 patients with LC who underwent splenectomy. Portal pressure significantly decreased from 22 to 17 mmHg after hepatectomy. Esophago-gastric varix improved in 74 % after splenectomy, and 100 % after Hassab's operation respectively. Platelet counts, serum albumin level, and prothrombin time level were significantly increased, and serum total bilirubin and ammonia levels were significantly decreased 1 year after the surgery. Hepaic encephalopathy disappeared in 4 cases, and IFN therapy was able to initiate in 2 cases.<BR>Although thrombosis occurred in 10 case (17 %), it didn't show any significant liver function derangements, and was successfully treated with anti-coagulant therapy. There were no other fatal complications.<BR>Splenectomy is worth attempting in patients with LC and huge splenomegaly because it improves portal hypertension, and several liver functions including platelet counts, and enables IFN treatment or treatment for hepatocellular carcinoma.
- The Japan Society for Portal Hypertensionの論文
The Japan Society for Portal Hypertension | 論文
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