Effects of splenectomy in cirrhotic patients ::estimation of liver function and liver regeneration using CT volumetry

概要

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We have previously reported that splenectomy in cirrhotic patients improved thrombocytopenia and liver function, which allowed to enable IFN treatment or treatment for Hepatocellular carcinoma. However there was possibility that this benefical effect on liver function could be due to IFN therapy.<BR>In the present study, we have retrospectively investigated the effect of splenectomy on liver function and liver regeneration using CT volumetry in 38 cirrhotic patients who underwent splenectomy without postoperative IFN therapy. Platelet counts, prothrombin time level, serum total bilirubin level, serum albumin level, and Child-Pugh score were improved 1 year after surgery. Liver volume was significantly increased with the improvement of Child-Pugh score 1 year after surgery in Child-Pugh classification B, C patients, however liver volume and Child-Pugh score were not changed in Child-Pugh classification A patients. Multiple regression analysis for liver regeneration rate using CT volumetry revealed the spleen weight as a significant factor. These results indicated that the inhibitory factor influencing liver regeneration might be present in the spleen, and splenectomy might accelerate liver regeneration in cirrhotic patients with Child-Pugh classification B.
The Japan Society for Portal Hypertensionの論文