کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4309070 | 1289300 | 2009 | 8 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Diameter of splenic vein is a risk factor for portal or splenic vein thrombosis after laparoscopic splenectomy Diameter of splenic vein is a risk factor for portal or splenic vein thrombosis after laparoscopic splenectomy](/preview/png/4309070.png)
BackgroundSplenomegaly is a risk factor for post-splenectomy portal or splenic vein thrombosis (PSVT) due to large splenic vein stump. The relationship between splenic vein diameter (SVD) and PSVT has not been established.ObjectivesTo investigate whether SVD is a risk factor for PSVT.MethodsForty patients who underwent laparoscopic splenectomy were analyzed. Preoperative and postoperative enhanced helical computed tomographic scans were obtained in all patients, and subsequent follow-up was performed in patients with PSVT during anticoagulant therapy. SVDs at the junction of portal vein (PV) 2, 4, and 6 cm from the junction of PV were measured preoperatively and postoperatively. Multivariate analysis was performed using logistic regression model.ResultsPSVT was diagnosed in 52.5% (21/40) patients. Preoperative SVD was significantly larger in patients with PSVT than in those without PSVT. Seventy-two percent of patients (16/22) with PSVT in splenic veins with a diameter of >8 mm developed PSVT. Multivariate analysis identified preoperative SVD as a significant and independent determinant of PSVT. At a cutoff value of 8 mm, receiver operator characteristic analysis for prediction of PSVT provided an area under the curve of 0.8552 (95% CI 0.821–1.000).ConclusionPreoperative SVD is a risk factor for post-splenectomy PSVT. We recommend measurement of SVD preoperatively in patients elected to undergo splenectomy, and a close follow-up of patients with SVD greater than 8 mm.
Journal: Surgery - Volume 145, Issue 5, May 2009, Pages 457–464